The main selling point, at least to Democrats, of the ObamaCare bill comes in its promise to insure most of the uninsured in America, through mandates (for the uninsured by choice) and through a dramatic expansion of Medicaid (for the uninsured by poverty). The latter group, which comprises about 14 million people, will become eligible for the program that combines federal and state resources for health insurance. But will they actually get medical care because of it? According to the governors of the states that run these programs, it’s doubtful it will actually help at all — and will bankrupt the states in the process:
But the states are having a hard time now and many say even a small share of insuring 16 million more Medicaid patients down the road will be tough.
“Every member of Congress will be hearing from their governor, from every political person in their state saying we don’t have the money,” said Jospeh Antos, a health care scholar with the American Enterprise Institute.
He added that Medicaid isn’t the ideal way to expand coverage.
“The point is not for everyone to get insurance, but for everyone to get good health care and Medicaid already has a problem in that regard,” said Antos.
He told Fox News that pushing 16 million more into that system will stress it to the breaking point. That’s because Medicaid reimburses so far below private insurance — even below Medicare — that Medicaid patients have trouble even finding a doctor.
“You can wait a very, very long time,” Antos said. “People talk about the problem with waiting lines, and rationing and so on. It’s happening right now in the Medicaid program.”
Indeed it is, and for the very reasons we have noted that ObamaCare will exacerbate for the rest of us. Not only will it encourage more utilization of health-care resources, it will create a money-losing demand on providers that will result in fewer resources for exponentially more people. The problems of access won’t get solved by this expansion; it will make the problem worse.
The states already know this:
Recent reports show doctors dropping patients because they were actually losing money on every visit. But the states are even more worried because they share the cost of Medicaid with the federal government.
“This is going to be a financial disaster for the states,” said Rhode Island Gov. Donald Carcieri. “Every state right now is battling Medicaid costs. After education aid, Medicaid is the next largest cost for every state.”
That is such a concern, it led to some of the biggest controversies of the entire reform effort. Sen. Ben Nelson, D-Neb., won what became known as the Cornhusker kickback in which the federal government was to pay Nebraska’s share of Medicaid forever. That brought howls of protest from California’s governor who said the mandate would cost his state billions of dollars.
“You’ve heard of the bridge to nowhere,” Gov. Arnold Schwarzenegger said. “This is health care to nowhere.”
The only way to fix that problem in the ObamaCare approach would be to raise reimbursement rates to entice more providers into the system. That, however, would make it even more costly for both the federal government and the states. Obama and Pelosi hope to redistribute wealth through the exchanges so that younger, more affluent, and healthier Americans get stuck with expensive plans they don’t need in order to shift those funds back around to cover the Medicare expansion. This is why the individual mandate is critical to ObamaCare — and why a court decision against it would effectively cripple it.
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