Medicaid Expansion: Adding Passengers to the Titanic
Published August 9, 2013
By Susan Myrick, Civitas Review online, August 8, 2013.
NBC 17 reports on the Durham City Council approving a resolution to urge Gov. McCrory and state legislators to change their decision to reject Medicaid expansion. A local group of medical care providers also held a press conference delivering the same message. The Council and protesters appeared to be fixated on the theme that rejecting the Medicaid expansion equated to somehow "denying" health care to some 500,000 people – the estimated amount of new Medicaid enrollees that would be added if NC accepted the expansion.
However, here are some facts that the folks clamoring for Medicaid expansion overlook:
- The federal government covers the cost of the new enrollees for only the first three years. But where would they get the money? Some estimates put the cost of expansion nationally at $118 billion over the next decade alone. If you haven't noticed, the federal government is broke.
- After the first three years, states would begin to pay a share of the additional costs. Some estimates place the cost of expansion to North Carolina at more than $3 billion over the next decade (these are likely very low). Where would the state get the money? State Medicaid spending has already shot up 42 percent in the last decade.
- Who will see the half a million new Medicaid enrollees? During a recent 8-year span, the state added 600,000 Medicaid enrollees, a whopping 50% increase in Medicaid patients. At the same time, the number of physicians accepting Medicaid patients decreased. The Medicaid system is already overcrowded, with enrollees having very limited access to actual medical care. What would happen if we jammed another half a million people into this program? That would be more than a million additional people crammed into a system chasing fewer doctors. Imagine adding a population roughly equivalent to all of Wake County into a system with already nearly 2 million people, all competing to see a dwindling number of doctors.
The bottom line is this: those advocating for Medicaid expansion want to condemn low-income people into an already overcrowded system that is simply incapable of providing adequate medical care. That's not compassionate – that's cruel.
August 9, 2013 at 7:52 am
George Doctoroe says:
This opinion column overlooks a key point. The federal government is broke only because our elected officials plunged us into foreign wars while cutting taxes, creating a deficit when we previously had a surplus. A modest tax increase would solve the problem quickly.
Canards such as 'the country is broke' do nothing to solve the problem and add to confusion, which I suspect was the motive of the column.
August 9, 2013 at 1:14 pm
dj anderson says:
Surprised the blog didn't mention the maladministration of Medicaid in the past in NC.
I'm not convinced there is a good argument for not expanding medicaid.
The worse case is that the federal government would stop paying for it. It is not mandated, so sequestration or budget cuts could throw the cost to the NC taxpayer at any time. The Federal government is going to borrow the money or print it. 16 trillion and counting, what's a bit more a year forever? This want of fiscal responsibility is an argument, but the state of NC can't control Federal debt.
I reject outright the argument that there are not enough doctors. People get treated now. As for doctors refusing medicaid, true reform should have fixed those problems and have included dental. Doctors that refuse Medicaid patients could have the government refuse them a licenses to write prescriptions. We need true health care reform.
The ultimate cost to the state of NC could be in the billions, and if so, would take money from education. So, there is the resistance to yet one more entitlement that exceeds our revenues.
Those on Medicaid pay $1 for doctor visits, for Rx, for dental. It's a great benefit without incentive for restraint.
All said, still, I just don't see why NC didn't expand Medicaid.
