Expanding Medicaid Is Economic Imperative

Hey, Dennis! Primary’s over! Where’s the special session?

Rick Knobe says it’s time to convene the Legislature to expand Medicaid. He says the Republicanism that has stalled South Dakota’s participation in this good portion of the Affordable Care Act hurts the poor and everyone else in South Dakota:

Our state Republican Leadership has chosen to be a low tax, low service, low wage state. While attractive to some greedy business people who give money to campaigns electing folks holding that neanderthal philosophy, it is costing us millions of dollars supporting people thru social service programs,  and charity. Also we are paying higher costs in law enforcement and mental health care, because poor people have a tendency to become desperate, depressed, mentally ill and find themselves on the wrong side of the law. Take a look at the pathetic state of the mental health programs, particularly in the state run Human Services Center in Yankton. Low service, low tax, low wages, hurt not just the poor, but all of us [Rick Knobe, It’s A No-Brainer Governor Daugaard Should Call Special Session On Medicaid,” KSOO Radio, 2016.06.03].

A new report from Georgetown University Center for Children and Families summarizes research showing that Medicaid expansion is saving states and hospitals money:

Although opponents of Medicaid expansion warned of new state costs, others anticipated that the substantial commitment of federal funds would allow states to save. Data from a recent study of 11 states bears out the promise of significant budget benefits from expansion. Expansion had significant fiscal effects on state budgets with savings ranging from $25 million in Kentucky to over $100 million in Washington State. Hospitals have experienced positive fiscal effects from state Medicaid expansions. A study of a single nonprofit Catholic multi-state hospital system with 131 acute care hospitals in 23 states and the District of Columbia compared performance between states. In Medicaid expansion states charity care costs decreased 40.1 percent compared to only 6.2 percent decrease in nonexpansion states. Research across states for all hospitals shows similar changes. In expansion states the rate of uninsured patient stays in hospitals typically declined by nearly 36.9 percent while the rate in non-expansion states of decline was slight: 2.9 percent. Other research reporting on major hospital systems in multiple states shows comparable declines in admissions of uninsured patients. For example, Hospital Corporation of America (HCA) members in expansion states had a 48 percent decline in uninsured admissions from 2013-14 as compared to HCA hospitals in non-expansion states where there was only a 2 percent decline in uninsured admissions. Research in specific states like Kentucky mirrors these studies, showing large drops in uncompensated care for hospitals compared to neighboring states that did not expand [links added; Adam Searing and Jack Hoadley, “Beyond the Reduction in Uncompensated Care: Medicaid Expansion Is Having a Positive Impact on Safety Net Hospitals and Clinics,” Georgetown University Center for Children and Families, June 2016].

Translation: the Koch brothers and ALEC allies are full of malarkey.

The Georgetown report proceeds to show that Medicaid expansion helps hospitals and clinics serving the poorest Americans stay in business and provide better service:

These safety net institutions in expansion states report using this increase in reimbursement to hire new clinical staff, open new health centers and clinics, buy new equipment, and improve existing facilities. One health center executive referred to the impact of Medicaid expansion as a complete reversal of financial fortunes. “We were at risk of laying off staff and closing health centers. The ACA has put us back in a growth position and has allowed us to build back up our reserves, give staff raises, and add staff to keep up with the volume of patient visits” [Searing and Hoadley, June 2016].

Giving raises and adding staff… hmm… might that have some economic development implications? You bethca:

Some non-expansion state executives noted the lack of expansion was leading to layoffs and closures. A hospital executive in one state reported that the system had to lay off “several hundred” positions in the last year and attributed these layoffs directly to lack of Medicaid expansion. Another referred to a “brain drain going on in [my state]. Folks say all things being equal I’d rather work somewhere else.” Media reports in some non-expansion states reinforce this story, with a hospital association executive in Missouri reporting 2,000 layoffs as a result of the state not expanding Medicaid. By contrast, leaders in expansion states reported on opening new facilities and expanding services in existing facilities. As a result most of those we interviewed told us they have hired new staff.

…An FQHC director put the impact on the community in a broader context. “One of the concerns is [whether] new business and employers want to come to a state that does not have an expanded Medicaid system . . . We are an unhealthy state so you are going to be hiring a lot of unhealthy people” [link added; Searing and Hoadley, June 2016].

Once again, even if I put on my old Republican hat and think business über alles, I look at the positive business effects of Medicaid expansion and the economic drag of our ACA foot-dragging and see that we must expand Medicaid.

Special Session, Dennis. Now.

11 Responses to Expanding Medicaid Is Economic Imperative

  1. owen reitzel

    save the state money? The far right should be all for this.

  2. There are likely more conservatives with common sense (although none are card carrying members of the Conservatives With Common Sense) in the legislatures now than there will be when the crazies start ranting.

  3. Pssst, Dennis just wants to blame the Indians for the issue at hand. Truth is, even the Koch Brothers are leaving dinosaurs like Dennis Daugaard in the tar pits to sink and decay. http://www.usatoday.com/story/news/politics/elections/2016/2016/06/09/exclusive-charles-koch-and-his-company-launch-end-divide-ad-campaign/85640226/?AID=10709313&PID=6155902&SID=ipb9cobzs000ei9w00dth

    South Dakota republicans own this lock stock and barrel, the continued blood is on their hands if they choose to keep this farce going. Democrats in the legislature should demand it passed and walk out if necessary to show solidarity for the working men and women of this state. After all, what is the purpose of the legislature if it cannot serve the needs of its neediest, put a tent on this republican circus for all to see its absurdity.

  4. The GOP party spends a lot of taxpayer money on corporate welfare under the guise of small-bore economic development. Then they turn away $100 million or so in Medicaid expansion money saying they don’t want it here. Schizophrenic is the best way I can describe it.

  5. I agree Cory. We’ve waited long enough. Its time to act or resign and let someone else do it.

  6. Catherine Ratliff

    There are countless situations where the working poor or disabled not-working poor desperately need Medicaid. The need for Medicaid is especially urgent where SSA and its administrative law judges wrongly deny clearly meritorious claims and too often the claimant dies before the favorable decision finally issues. It is a cruel system.

  7. Dennis and his minions could give a care about their fellow human beings in the state as they grew up tearing the legs off grasshoppers and other ways to practice being who they are today. Hide and watch, the majority of these same legislatures and I would say the governor himself, has seen Medicaid in action with a family member. These kinds of people have gamed the system to hide assets and to generally cheat their way into putting family and friends into nursing homes at taxpayers expense. They all know how it works, it is that they think it is their own piggy bank. Some news outlet should ask each one of these high and mighty hypocrites how that Medicaid has worked for their family. Start with the newly winners of the primary and work to the old dogs there.

  8. Jack Shaftoe

    For goodness gracious sakes, the mortality rate in middle aged and older members of the lower income people of the US has been steadily increasing! About seven hundred thousand families are bankrupted each year for medical expenses that they and their capitalist insurance plans won’t and can’t cover. Let’s have some blather from conservatives about “the shining city” and “exceptionalism, hmmmm, or maybe Christian values?

    The Heritage Foundation (very conservative advocate think tank) came up with the idea about Romneycare/Obamacare 20 or more years ago as a means to help small main street businesses keep good, knowledgeable and qualified employees who were leaving for jobs with larger companies who offered health coverage to many of them, especially those with young, beginning families. It would help keep these small town bike shops or shoe and clothing stores etc. on the Main streets all over fly-over country.

    But, what has happened is a bunch of radio talk people started blasting it (I’m sure, at the suggestion of a variety of corporate owners) and our conservative politicians in state legislatures and the US Congress have waged all out war against it. We, after all, have made bribery, excuse me, unlimited campaign contributions or “speech” as we now know it – perfectly legal. It isn’t even subtle as some of the legislative maneuvering used to be, but more along the lines of openly clubbing these plans to force a failure so they could tell us how evil “socialized” anything is. Gosh, you mean we could bargain with these parts of the health care industry for lower drug prices and lessen the bizarre charges for a hospital stay? Hell no, can’t have that, because everything, – everything, has to return a holy profit, as God wants it!

    Some years ago, a relative took his wife to the hospital where she gave birth rather quickly to their first child. They were uninsured at the time, but he had started a business and was wildly successful and had no problems affording it at the time. When he went to the hospital to pay his bill, he found a number of “standard” charges for things that she hadn’t received. One of those was a pre-birth enema. He said he didn’t think they should be charged for that (and a number of OTC medications and paper products), and was told these were just customary. He said that, in his business, if he just added in “customary” charges for services or things he didn’t provide – not only would he expect his customers to find it unacceptable, but that he could and should be charged with fraud. The accountant for the hospital wouldn’t budge on removing charges for services unrendered etc. and this relative became more unhappy and a little animated. Finally the administrator was called to come talk to him. The administrator gave him the same boiler plate and my relative flat refused to, as he put it, “be robbed”. Finally my relative suggested that the medical staff give the administrator the enema and he would pay for that. As it panned out, some of the bill was “adjusted” but he still was required to pay what was a hefty surcharge.

    I had a hospital stay for surgery in 2006. I was covered by insurance etc.. I looked at the bill and had requested more information – just for interest on my part – and the room – no surgery or any other charge, was $26,000.00 for 4 days. I’m not for total socialism. I see parts of society that function very well under capitalism – for the most part, but why in the world are there segments where with life and death issues, we cost people out of everything and as they get sicker and have been tapped out, their alternative is to die?

  9. Jack Shaftoe

    Mike from Iowa, How very true-nice meme.

  10. mike from iowa

    In case you are not convinced about Wingnut Kompassionate konservatism-here is the first tweet out of indicted Texas Attorney General about the worst mass murder in US history today.