Some ideas, no matter how bad, never seem to go away.
How else to explain state lawmaker efforts to expand Medicaid under Obamacare? After Gov. Sam Brownback rightly vetoed an expansion bill in March, and after the Legislature failed to override that veto, special interests that stand to benefit from this growth in government are pressuring lawmakers to try yet again during the current veto session.
Lawmakers who care about improving the quality of health care for the least fortunate — and who care about taxpayers’ long-term interests — should reject these attempts.
Designed to provide insurance to the most vulnerable patients such as the elderly, disabled and pregnant women, Medicaid has a long history of costing more but delivering less. A 2012 Manhattan Institute report, which examined health studies from the previous decade, found that Medicaid patients lack access to basic and specialist health care and “have the worst health outcomes of any group in America — far worse than those with private insurance and, in some cases, worse than those with no insurance at all.”
Nonetheless, when Obamacare declared that the federal government would cover the cost of Medicaid expansion — 100 percent from 2014 to 2016, before falling to 90 percent by 2020 — 32 states and the District of Columbia took the bait.
But this “free money” has turned out to be rather expensive. In every expansion state, enrollment has far exceeded expectations, causing serious sticker shock from Illinois ($2 billion over budget in the first two years), to Kentucky ($3 billion over budget in the first two and a half years), to California ($14.7 billion over budget in the first year and a half).
In every instance, state Medicaid spending skyrockets along with federal costs. For example, Illinois’ estimated spending on Medicaid expansion from 2017 through 2020 was revised up from $573 million to $2 billion, a more than threefold increase. In Oregon, it was so costly the state is now considering ending it to fill a $1.6 billion deficit.
While the price is shocking, the health care results are underwhelming. A study published this year in the New England Journal of Medicine reports that Medicaid “expansions were not associated with significant changes in … health status” and “challenges in access to care persist.”
The simple truth is that health coverage and access to quality health care are not one and the same. Medicaid patients in Kansas already experience delayed care because of the declining number of doctors willing to accept new Medicaid patients. Worse yet, under the Obamacare expansion, the majority of new Medicaid enrollees are able-bodied, childless, working-age adults who crowd out the most vulnerable for whom the program was intended.
Still, in a move that flies in the face of common sense, some Kansas lawmakers and lobbyists want to give it a go.
Their latest claim is that Medicaid expansion will save failing hospitals in our state. Obamacare supporters in Kentucky and Arkansas made similar promises, and the states both lost hospital jobs and an Arkansas hospital closed. Time and again, Medicaid expansion overpromises and underdelivers.
Rather than expand a failed program, we need real, patient-centered reforms that expand access to health care. Let’s broaden the scope-of-practice laws so nurse practitioners and other health care professionals can treat more patients. We should encourage innovation by eliminating regulations on things like telemedicine, and reform medical malpractice laws that contribute to ever-rising health care costs. And we should remove the barriers that keep family and primary care practices from thriving.
These reforms will increase access to quality care without breaking the budget.
Kansas voters don’t want more federal government control over health care in our state; on that, they’ve been clear. Lawmakers should take note and drop Medicaid expansion once and for all.
Jeff Glendening is the Kansas state director of Americans for Prosperity, a free-market think tank.