The danger of Medicaid expansion
Opinion/Health Care and Government
The past few months, Gov. Laura Kelly has made it known that it is her mission to grow the government through Medicaid expansion. She has pushed a lot of misinformation surrounding the topic, so today, we are taking a deep dive into what Medicaid actually is, and debunk some of the lies the Democratic governor has said.
A Brief History of Medicaid
When it comes to the health care system, it is lousy with government regulations. It’s an absolute monster to fully understand everything in it. However, to state the obvious, for over a century the U.S. government has been infringing in the health care system. Like with any system the government gets its tyrannical little hands on, it ultimately made the system worse off than it would have otherwise been. Medicaid and Medicare were one extremely damaging way the government infringed on the system.
In July of 1965, President Lyndon B. Johnson signed the Social Security Amendment of 1965 into law creating Medicaid and Medicare—two of America’s most enduring social programs.
It is important to understand the differences between Medicaid and Medicare. Medicare is a government health insurance at the federal level for people age 65 and older with certain disabilities and conditions. Due to this government program being at the federal level, Medicare coverage will be the same regardless of what state a person lives in.
Medicaid is a joint federal and state program that helps cover medical costs for some people with limited income and resources. All state Medicaid programs must follow some general rules provided by the federal government, but individual states run their own program—meaning eligibility requirements and benefits can vary state to state.
Originally, Medicaid gave medical insurance to people receiving cash assistance. However, as time has gone on, the government has grown to cover a much larger group of people, including: low-income families, pregnant women, people of all ages with disabilities, and people who need long-term care. This being the government, it really didn’t take too long to see them grow in power. In fact, just two years after the Democratic President created Medicaid, in 1967, Social Security Amendments were added to cover individuals with disabilities as well as providing children under the age of 21 with appropriate screening, preventive care, and treatment services. And the government has only expanded quickly from there.
Since the 1980s, Medicaid enrollment has expanded so much that by 2015 two out of three Americans had some sort of connection to the government program. This is either through themselves, a family member, or a close friend being currently or previously enrolled.
Beginning in 2014, states were provided the authority to expand Medicaid eligibility to individuals under the age of 65 in families with incomes below 138 percent of the Federal Poverty Level (FPL) thanks to the Affordable Care Act (ACA).
To see the full timeline of Medicaid expansion, click here.
Why Medicaid expansion would do more harm than good
One of the biggest lies government expansion advocates like Gov. Kelly has been pushing is that by expanding Medicaid, rural hospitals will be “saved,” despite this claim making no economical sense. In fact, nearly 50 hospitals in expansion states have closed between 2014 and 2022 (roughly 6.25 hospitals a year), leading to a loss of nearly 5,400 hospital beds, including nearly 500 rural beds. It’s even been shown that Medicaid expansion is actually a direct cause of hospital closures in some cases. Meanwhile, 95 percent of hospital closures in non-expansion states cited other reasons for closure that did not include Medicaid expansion. The number one reason for their closure was simply a decline in utilization (28.8 percent). Of the five percent of hospitals that did cite a lack of Medicaid expansion as a reason for closure, it was found that half of them were involved in alleged fraud schemes or severe financial mismanagement. We can even look to Oswego Community Hospital here in Kansas who blamed lack of expansion for it failures. However, a year later, its managers were charged in a $1.4 billion fraud scheme.
Gov. Kelly has also made the claim that expanding Medicaid would “lower costs for everyone in every corner of the state.” However, this is also not true, and Medicaid, historically, has made healthcare less and less affordable. In fact, prior to Medicaid and Medicare, healthcare costs were low and stable to a point that most people didn’t need major-medical insurance. Since Medicaid and Medicare were implemented, the cost of healthcare has increased at a rate of more than twice the rate of inflation. We are being taxed so heavily on Medicaid as well that Medicaid actually represents $1 out of every $6 spent on health care in the U.S. And while there may be a coverage gap, it is important to remember that it was unnaturally created through government expansion, and as Medicaid and Medicare continue to expand, we will likely see more people being reliant on government or in that gap until private health insurance is only for elites.
Gov. Kelly has also argued that Kansas is losing out on Kansas tax dollars at the federal level. A total of “$6.6 billion so far.” To that I say, can you imagine how much more affordable everything would be if the government didn’t steal $6.6 billion from us? What Gov. Kelly is talking about is President Joe Biden’s ironically named “American Rescue Plan,” which incentivizes states to grow their governments via Medicaid expansion. This was done by offering the states additional federal funding if the state expanded Medicaid to eligible low-income adults. There are a couple of other things this would do, but the thing Gov. Kelly is really highlighting is that under the plan, states would gain the ACA’s 90 percent federal matching funds to pay for the cost of newly eligible adults. However, the Supreme Court found in 2012 that states cannot be mandated to grow their government through Medicaid expansion, allowing states to keep their preexisting level of Medicaid without risk of losing federal funding. To suggest that we are “losing out on $6.6 billion” rather than the reality of being overtaxed by a tyrannical government shows a level of delusion that is becoming all too common.
Conclusion
More government is never the answer, and looking back at the epic failures of the government during the pandemic should terrify people from ever wanting government to have more power over the healthcare system. I am a big believer that Medicaid and Medicare need to be stripped away completely in order to see a better, more affordable healthcare system. However, if Medicaid is something you are hard pressed to let go of, Americans For Prosperity has worked hard to push for a better solution to medical expenses: The Personal Option. Their idea is to expand health savings accounts, bring price transparency to medical costs, and provide more choice by removing barriers that keep people from reaching the doctors, nurses, and facilities they need—giving people necessary access and control while keeping healthcare affordable. This Personal Option is one I have looked into and believe in as the true future for affordable healthcare for all. NOT government growing in power.
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Excellent overview of the FACTS.