The coming Medicaid decisions

A physician looks at Medicaid’s future:

On June 23, recently failed former Democratic Party presidential nominee Hillary Clinton tweeted, “Forget death panels! The GOP is the death party!” Sen. Elizabeth Warren chimed in on the Senate floor: “These cuts are blood money! People will die!”

The Democrats and their media allies claim the Republican Party’s proposed health care reform will result in massive numbers of premature and unnecessary deaths by Medicaid recipients who lose their coverage.

The left has cried “Murder!” ever since welfare reform was signed by President Bill Clinton in 1996. The scenarios of starvation, disease and pestilence due to reforms of government entitlements never materialize quite like they predict. But in the health care case, the Democrats have picked an entitlement to champion that—like welfare—not only kills incentives to work but itself kills patients, 0r, at least, cannot be proven to actually save lives.

Few people realize that the highly touted expansion of insurance coverage, which is the key accomplishment of the Patient Protection and Affordable Care Act (PPACA, or Obamacare) was 75 percent due to Medicaid expansion. The law promised the federal government would pick up 100 percent of the cost of the new enrollees—for the first three years, which ended in 2016—and 90 percent after that. Federal promises to pay the states for Medicaid expansion are eerily reminiscent of promises made to Native Americans to honor treaties so long as the sun shall shine and the grass shall grow—which, in this case, means 10 years max. Congress is broke.

Yet 31 governors, including Nevada’s Gov. Sandoval, bought into the program. Medicaid expansion in Nevada to 138 percent of federal poverty level created 277,000 new enrollees, and Medicaid is projected to reach over 20 percent of Nevada’s population, or 800,000, by 2023. Of these, 371,000 projected enrollees will result from Medicaid expansion. Nevada’s Medicaid expenditures are expected to cost an additional $5.4 billion above projections without Medicaid expansion. Obamacare severely restricts the ability of Nevada to reduce eligibility for expansion or to reduce coverage. The Republican reforms would at least provide more flexibility to Nevada.

The pre-Clinton Aid to Families of Dependent Children program was exposed by a Democrat, Nixon aide Daniel Patrick Moynihan, for its destructive effects on the family structure of the poor—in particular, what had previously been the strength of the black community, the two-parent family. The Democrats fought to the bitter end against welfare reform. Medicaid is another corrupt hill for them to choose to die on, yet die they seem determined to do. The Republicans, as usual, will likely meekly pull back from real reform and tinker with the program at the margins instead of liberating the poor from the clutches of this awful government disaster.

Medicaid is the poster child for Republican rhetoric that merely having insurance does not mean you have health care. Fully 30 percent of doctors refuse to see new Medicaid patients because the red tape and poor compensation is not worth it. As a result, Medicaid patients visit the emergency room three times more often than even the uninsured. Only 20 percent of dentists accept Medicaid. The left continues to ignore the greatest problem with government health care—the frustrating delays involved with receiving actual care, which results in poor health outcomes, including unnecessary deaths.

Now, who exactly are the murderers?