John Archibald of AL.com wants Alabama conservatives to know that they’re being childish by not wanting to expand Medicaid under ObamaCare. “Petulance,” he says, is one of the main reasons conservatives are pushing back.
Archibald also wants Alabama’s governor, Dr. Robert Bentley, a man who knows a thing or two about, you know, actual healthcare, to know that he’s being “recalcitrant” because he doesn’t want Alabama to have to participate in the president’s disastrous healthcare law any more than it absolutely has to.
Archibald is only one of a growing number of left-leaning members of Alabama’s political class who have reached the point of exasperation because of Alabama’s refusal to kowtow to the Obama administration’s every whim and demand.
Here are the barebones facts:
Expanding Medicaid under ObamaCare would mean the program would cover adults who earn up to 138 percent of the federal poverty level. The federal government promises to pay 100 percent of the expansion’s cost for the first three years, then would start decreasing in future years down to 90 percent.
First of all, it’s all our money.
Whether the state government pays for it or the federal government pays for it, that money comes out of the pockets of taxpayers. So the idea that this is “free money” is a classic liberal fallacy. As the famous free market economist Milton Friedman once said, “There’s no such thing as a free lunch.”
Furthermore, even if the state government is only on the hook for ten percent of the cost of expanding Medicaid after the first three years, where is that money going to come from?
Do we have hundreds of millions of dollars laying around every year that I don’t know about?
Last time I checked, Alabama’s just-under-$2 billion General Fund Budget is a disaster, getting by on $146 million borrowed from the Alabama Trust Fund and $50 million from a one-time tobacco settlement. Medicaid is already by far the largest line item in the general fund budget, making up almost 60 percent of Alabama’s non-education related spending.
With Alabama’s prison system teetering dangerously close to being taken over by the federal government for lack of funding and our judicial system on financial life support, the prospect of dumping more money into Medicaid just doesn’t make any financial sense.
And all of that is assuming that the federal government would even deliver on its promises when it comes to Medicaid expansion. As we’ve seen recently, the current Administration has no qualms with going back on its word.
Federal budget cuts are coming. Even many Democrats realize that the federal government can’t sustain its current big-spending ways. When those inevitable budget cuts come, is Medicaid somehow going to be exempt?
“If you expand Medicaid, we’ll cover at least 90 percent” could very well be the next “If you like your health insurance, you can keep your health insurance.”
But it gets even worse. Many doctors are warning that they simply can’t handle any more Medicaid patients.
A whopping 33 percent of primary care physicians are already not accepting new Medicaid patients, according to a study by Health Affairs, a journal focusing on healthcare policy.
“As Medicaid expands next year under the Affordable Care Act, some American doctors say they won’t be accepting anymore low-income patients for the program’s low pay,” Medical Daily wrote just yesterday.
“Patient access to doctors is approaching a perfect storm of decreased physician supply, more demand for medical care — especially after ObamaCare kicks in — and doctors increasingly refusing to see low-paying Medicare or Medicaid patients,” Forbes reported last week. “A growing number of doctors are refusing to take new Medicaid or Medicare patients, and there is every reason to think the same will happen under ObamaCare.”
Finally, proponents of Medicaid expansion continuously cite a “study” commissioned by the Alabama Hospital Association which claims that 30,700 jobs will be created in Alabama by expanding Medicaid. Gov. Bentley, realizing that the Association’s member organizations stand to gain financially more than anyone from the expansion of Medicaid, astutely called the study “bogus.”
If piling more people onto government healthcare rolls is that great of an economic catalyst, why don’t we just expand Medicaid to cover every single person in the country? Government healthcare for everyone! Jobs for everyone!
“Bentley has argued that Medicaid is flawed and unsustainable, that his goal is to resist implementation of the Affordable Care Act,” Archibald bemoaned. That logic is “putting politics above his people,” he concluded.
In opposition to the federal government, Alabama should be looking for ways to make higher quality private health insurance more affordable and more accessible. Expanding Medicaid will do exactly the opposite — further crowding low-income earners out of private insurance and compelling them to put themselves on the government’s rolls.
The federal government’s un-welcomed intrusion into the health insurance marketplace has been a disaster for the economy and is threatening to dismantle the world’s greatest healthcare delivery system.
Alabama should not make matters worse be further entangling ourselves with the federal leviathan by expanding Medicaid. It will hurt our doctors. It will stretch our General Fund Budget to the breaking point. And it will make us even more reliant on an incompetent, overreaching federal government.
Hold the line, Governor Bentley. We’ve got your back.
Follow Cliff on Twitter @Cliff_Sims
