The Human Cost of Red States’ Middle Finger to Medicaid Expansion
The Kaiser Commission on Medicaid and the Uninsured is out with a new study illustrating the sickening human cost of the Red States throwing a middle finger to President Obama on the Affordable Care Act’s (ACA) Medicaid expansion. Twenty-one states are not expanding Medicaid coverage under Obamacare and would gain considerably more than the 23 states that are expanding eligiblity. Partisans like Texas Governor Rick Perry and Kansas Governor Sam Brownback govern states with the highest rates of uninsured — and millions of their own citizens won’t get health insurance so they can score cheap political points.
In states that are expanding Medicaid under the ACA, the average percentage reduction in the number of people without health insurance is 40.9 percent. But in the states not expanding Medicaid, the average reduction of uninsured would have been 52.5 percent. The debate over Medicaid expansion continues in six states. The average rate of reduction in those states would be 54.1 percent.
Kansas is a great example of the dereliction of duty to the public good Red State governors and legislatures are engaged in, solely for “principled” resistance to the President’s signature accomplishment. The number of uninsured people in Kansas would be reduced by almost half, or 47.6 percent, by accepting the Medicaid expansion funds in ObamaCare. But state legislators and Governor Brownback earlier this year chose to go against expansion, citing concerns about future costs.
Currently, the federal government covers about 60% of Kansas Medicaid costs. You’ll recall that under the ACA, the Feds initially would cover 100% of the costs for newly eligible enrollees, and no less than 90% of those costs over the long term. So the cost argument tossed up by so many Red States is a farce, a sop to fiscal conservatives with no basis in fact. What they’re really thinking is that those eligible for the expansion will skew Democratic in the voting booth, so why do anything for them? Kansas legislators actually passed a law barring the Governor from expanding Medicaid without “express approval” from the Legislature, which won’t meet again until January.
Kaiser’s report shows that expanding Medicaid in Kansas would cover an estimated 144,000 additional Kansans, and cost the state about $525 million over the first 10 years of the expansion. If Kansas does not expand Medicaid, the state won’t receive about $5.3 billion in additional federal Medicaid funds 2013-2022, and Kansas hospitals would receive about $2.3 billion less in state and federal Medicaid funds for uncompensated care over the same period. So we’re talking a huge net gain for the state in Medicaid funding if they expand, and a huge cost, both in state coffers and the human toll of not expanding. This makes the Red State cost argument baseless, and shows the raw, awful politics of ObamaCare at the hands of right-wing partisans.
The shameful thing about the unprecedented resistance to ObamaCare in Red States is that all those elected officials, from Brownback to Perry to the Florida State Senators who thwarted expansion, all took oaths of office to protect and serve their constituents, regardless of their party affiliation or insurance status. They’re showing their true motivation, which is only to support laws of the land that benefit people who look and vote like them.
I, for one, hope they reap the whirlwind when those constituents figure out they didn’t get something as vital as health insurance so their elected officials can have a punchline for a campaign ad.
Resources
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