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Medicaid Masochism

By Dr. Chris Lillis

The Affordable Care Act is now three years old.  It has been nearly a year since The Supreme Court released its decision upholding the constitutionality of the law.  Yet some opponents to this landmark legislation are still weighing the political considerations of implementing the Affordable Care Act in their State rather than considering the needs of their state residents.  

One of the most ludicrous examples I have read about recently is the current proposal emerging from Wisconsin.  The politicians are currently adamant not to accept Medicaid expansion dollars included in the Affordable Care Act (ACA), leaving $600 million in Federal funding on the table.  This may seem like a political victory to refuse the implementation of the ACA, but it leaves 181,000 Badgers without access to health insurance through the Medicaid program.  The end result?  Wisconsin is going to INCREASE its state spending by hundreds of millions of dollars to compensate hospitals that will be losing disproportionate share payments while being denied the benefit of providing less uncompensated care. 

So, let me get this straight…Wisconsin residents pay taxes, correct?  They pay federal income taxes, state taxes, sales taxes, Medicare and Social Security taxes.  Wealthy residents of Wisconsin are going to be paying a higher Medicare tax rate as this is one of the provisions of the ACA that raises revenue to offset its costs.  Those taxes pay for the provisions of the ACA like Medicaid expansion, meant to cover the uninsured in Wisconsin, thereby reducing the annual losses of the hospitals in Wisconsin that previously have provided uncompensated care.  Wisconsin will no longer experience the job growth in the health care sector to help take care of the additional 200,000 individuals who would be able to pay for their health care through expansion.  And those newly covered individuals will not get the chance to have lower healthcare costs and thereby have more money to spend in the Wisconsin economy.  The end result is Wisconsin residents forfeiting thousands of jobs and over a billion dollars in economic growth just in the first few years of expansion.   All this to score a political victory.  I wonder how Wisconsin residents feel about paying more and getting less?

But Wisconsin is not alone.  This interactive site shows that fifteen states are currently refusing Medicaid expansion and another six are “weighing their options.”  Check out if your state is among the 30 who are choosing to expand their economies and help the uninsured, or among the politically craven who are cutting their nose to spite their face.  But please don’t stop there.  If your state is choosing the route of masochism, learn about the economic consequences here

It is no wonder that hospitals, local and state chambers of commerce, provider organizations and consumer advocacy groups are throwing their support behind Medicaid expansion.  My question through all of this: who is against this besides the politicians?  

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