Does any state regret expanding Medicaid under the Affordable Care Act (you know, the signature legislation of President Barack Obama that, fourteen months later, Donald Trump and the Republican Congress have, against their most fervent promises, failed to repeal)? Montana certainly doesn’t, with Medicaid expansion boosting the economy and paying for itself.
Apparently neither does any of the 31 other states that have taken the great ACA deal to have the federal government pay for 90% of the cost of offering Medicaid to households making up to 138% of the poverty line. A new policy brief from the Brookings Institute says that expansion states are finding that adding Medicaid enrollees are a benefit, not a burden:
One reason new enrollees do not substantially burden states’ Medicaid budgets is that expansion absorbs some of the costs states were already bearing prior to expansion. Various categories of previously covered Medicaid recipients (such as “presumptive” enrollees) can now enroll under the ACA’s expansion program, such that, according to federal (CMS) data, over 20 percent of expansion enrollees were not “newly eligible.” This shift in enrollment reduces the state’s share of their Medicaid expenses. Also, expanded Medicaid pays for various costs that states previously were absorbing outside of Medicaid. Accordingly, several credible and expert evaluations (including one in the New England Journal of Medicine) show that states such as Arkansas, Indiana, Kentucky, Louisiana, Michigan, Montana, New Mexico, Ohio, and West Virginia (among others) have actually reduced, not increased, state spending as a result of expansion [Mark Hall, “Do States Regret Expanding Medicaid?” Brookings Institute, 2018.03.26].
…and that claims to the contrary are mostly bunk:
There are reasons to question the accuracy or objectivity of the contrary evidence presented by some expansion opponents. Perhaps the leading source is the ultra-conservative Foundation for Government Accountability, which (according to journalist and academic reports) campaigns aggressively against Medicaid expansion across the country. Various credible and respected sources (including a federal judge, a Pulitzer prize journalist, and both liberal and conservativelegislators and analysts) have concluded that it produces and disseminates information and analysis that, based on “even a cursory review,” is “not competent,” “bogus,” “highly misleading,” “fundamentally flawed,” “oversimplistic and exaggerated,” “absurd,” “a parade of alternative facts designed to obscure the simple truth,” “misrepresents or omits data,” and presents “a myriad of misleading and irresponsible statements” [Hall/Brookings, 2018.03.26].
(By the way, those links are all in the original. That’s the way to cite sources in the 21st century! Links make for richer reading.)
The Brookings Institute notes that while several states passed laws that would automatically repeal their Medicaid expansions if costs ran higher than expected, not one state has had to pull that trigger.
So remember, ACA repeal hasn’t failed because of Trump’s endless scandals or executive incompetence. It hasn’t failed because Thune, Rounds, Noem, and other Republicans can’t legislate their way out of a Hy-Vee bag. It has failed because the Affordable Care Act works. Just ask any state that has expanded Medicaid.
Related: Governor Gary Herbert of Utah just signed a bill to partially expand Medicaid. Utah activists are trying to place full expansion, which has majority support in the latest polling, on the November ballot.
Also Related: This month’s Kaiser Health Tracking Poll finds that 59% of Americans support Medicare for All, providing health insurance to all Americans through a single federal government plan. 75% of Americans support offering Medicare as a public option.
Medicaid expansion is funding narcotic addiction. Way to go.
I read one article (no I don’t remember the link) that stated that pregnant women on Medicaid are using twice as many opioids as pregnant women on private insurance.
Because treating a symptom (pain) is easier and cheaper than treating the cause.
I know one graph of opiod abuse in New Hampshire showed an exponential increase as soon as they expanded Medicaid.
Oh sure the medical bills are getting paid.
Wait till they have to educate all those NAS kids.
You have to quit watch Trump…excuse me Fox News Anne. Here is a link that proves your theory wrong.
https://www.healthaffairs.org/do/10.1377/hblog20170823.061640/full/
There are three things fueling the narcotic problem. The first was the idea of “pain” as the “fifth vital sign.”
Never mind that unlike the objective measurement of temperature, pulse, respiration and Blood pressure, pain is subjective, if the patient reports pain, it’s real. And any practitioner who declined to treat it was deeme guilty of negligence.
Then there was the withdrawal of propoxyphene from the market in 2010. It was an effective analgesic which was not particularly addictive. It was replaced by hydrocodone and oxycodone, which turned out to be very addictive.
And then to pay for all of this, we got Medicaid expansion. The downside of that is that Medicaid reimbursement is not very good, and clinics lose money on these patients.
I had a doctor advise me to use physical therapy, not pain pills (even OTCs) for any pain that I have. Anybody who has had PT knows it costs a lot more than Tylenol. Medicaid is not going to pay for PT when the patient will be satisfied with pills. That is just a fact. I was in health care long enough to hear the explanation “Medicaid won’t pay for it” often enough, with the patient offered a less satisfactory treatment plan. The patients are seldom aware that a better treatment is available to people on private pay.
I will not reveal the name of the hospital or the CEO who said this, but he said it publicly twice (the first time I heard it I was sure I must have misunderstood):
“Since the public is unable to evaluate the quality of the health care they receive, it is more important to produce the appearance of high quality care than it is to actually deliver it.”
You just think about that for a while.
As long as you believe that your family member received state of the art care, it won’t matter if he or she would be still alive if you had taken them somewhere else. Because you’ll never know the difference.
Medicaid Expansion has been approved in conservative Utah.
Anne please don’t blame the opioid problem on the Medicaid program. Big Pharma and doctors are to blame. There is a lot of money to be made by pharmaceutical companies to keep Americans addicted.
Legalizing medical marijuana would help to curtail rising healthcare costs.
Cannabis has helped so many people with pain, not to mention anxiety and depression. In MN medical cannabis has been approved for obstructive sleep apnea and PTSD and right now they are petioning to have it approved for dementia and Parkinson’s. Meanwhile South Dakota is stuck in the Middle Ages.
Anne – – If the “CEO” said it “publicly,” why can’t you reveal his/her name ??
oh Anne do u know anything about addiction or are you just trying to shoot down intelligent healthcare choices by 31 states? additive substances create craving in some people’s biology and they cannot biologically overcome it. it becomes an illness you can not wish away. share some more stigma, would you? https://www.drugabuse.gov/about-nida/noras-blog/2018/03/what-does-it-mean-when-we-call-addiction-brain-disorder
“… still alive if you had taken them somewhere else. Because you’ll never know the difference.” what a silly argument
Ms. Beal is indicating that she is supportive of suicide by drug addition. Simple as that. When you have Medicaid Expansion, you can get mental health treatment. These are the kinds of treatments that have been proven to deal with depression. Ms. Beal should talk to her fakey CEO about the ramifications of untreated depression that walk hand in hand with opioid addiction/suicide.
The US treasury just borrowed 300 billion today, so money is not an issue here. We have plenty to fund Medicaid Expansion without a blink. http://money.cnn.com/2018/03/27/investing/us-debt-sale-record-treasury/index.html
Anne, you’re posting a lot of unsourced assertions on my blog. If the statement you quote was made publicly, then there is no reason not to name the CEO or hospital.
Anne is being rebutted effectively by multiple commenters citing actual information that we can all check for ourselves.
Strangely, neither Montana nor any other state discussed in the evidence I provide says, “We regret expanding Medicaid because it is increasing opioid addiction.” Either the states (including states led by Republican governors) haven’t noticed this problem, they are hiding this problem, or this problem does not exist.
So what will the States do when the Federal Government stops funding it?
I suppose the states could, I don’t know, stop funding it if the Feds stop funding it.
We’ll burn that bridge when Trump tries to cross it, Jason. So far, he hasn’t done it. The information I cite shows that he shouldn’t, because states are finding it very useful.