A question for those who say expanding Medicaid is a no-brainer
Liberal think tanks and columnists have been cranking out the arguments about why a state like Georgia would be foolish to reject Obamacare’s expansion of Medicaid. The expansion, which was made optional for states in the Supreme Court’s June ruling upholding the bulk of the law, would cost Georgia an estimated $2.5 billion over 10 years, according to state officials. Gov. Nathan Deal has said our state will not participate, but Obamacare supporters are trying to pressure him to change his mind.
Proponents of the expansion say hospitals and doctors in the state would receive an additional $33 billion in federal funds during that time frame. To hear them tell it, this is tantamount to finding $33 billion in between the couch cushions; they never mention whose pockets it’s falling from.
“The economics of this are very strongly in favor of adopting the expansion,” said John Holahan, study co-author and director of health policy research at the Urban Institute, in a recent AJC story. Holahan’s study puts the total federal cost of expanding Medicaid via Obamacare at $952 billion over 10 years if all 50 states participate. That’s a 26 percent increase on top of what’s already one of the federal government’s fastest-growing budget items. And, for you non-math majors, that comes out to $95.2 billion per year on average.
But here’s my question: Where do we find another $95.2 billion per year in a Washington that is currently:
- running annual deficits of at least $1 trillion;
- trying desperately to avoid an automatic spending cut (the “sequester” portion of the fiscal cliff) that would shave about $133 billion per year on average (over the next nine years);
- and discussing tax increases on “the rich” that would raise, at most, $160 billion per year?
No one in Washington seems to be talking seriously about deeper spending cuts or sharper tax increases than these, so we are talking about continuing to run annual deficits of well over half a trillion dollars before tacking on $95.2 billion in new Medicaid spending.
And remember: This is just the Medicaid portion of Obamacare. We’re not talking about subsidies for the federal exchanges or new costs for long-term care.
Why is it that none of the “found money” advocates ever explain how we’re going to pay for this new spending? Or do they think Georgia taxpayers will truly believe someone else will handle that federal portion of the cost?
– By Kyle Wingfield
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308 comments Add your comment
Nunna Yobinnes
November 27th, 2012
2:58 pm
I want my free stuff.
real john
November 27th, 2012
3:00 pm
Thank you Kyle…I had to point this out on Bookman’s blog the other day when he was talking about the “free” money Georgia would be missing out on.
As I pointed out to him, it’s either coming out of my federal taxes or my state taxes, but it’s still has to be paid for. In essence, it would costs Georgia $33 + $2.5 billion for a grand total of $35.5 billion in money WE DON’T HAVE.
Of course Obama and the idiot liberals are actually trying to argue that Obamacare will LOWER the defeceits by adding millions to Medicaid. These are the same people who preach about science of global warming but can’t do simple math.
Thomas Heyward Jr
November 27th, 2012
3:00 pm
“Why is it that none of the “found money” advocates ever explain how we’re going to pay for this new spending?”
.
Washington will do what they ALWAYS do.
Increase the taxes on cigarettes, gas, and booze.
.
And the health nazis, global-warming weirdos, and other various nerds will cheer.
Dave
November 27th, 2012
3:00 pm
“…before those poor gullible people with the trillions of dollars get wise to us?”
Love it.
Kyle Wingfield
November 27th, 2012
3:01 pm
JDW @ 2:54: But if we don’t incur the costs, we aren’t accumulating the debt. It’s not as if Georgia is the only state considering staying out of this program.
JDW
November 27th, 2012
3:05 pm
@Kyle…”But if we don’t incur the costs, we aren’t accumulating the debt.”
Yes, yes we do…the CBO numbers you reference account for the fact that Georgia and other states may opt out. No matter what we will be incurring our pro rata share of the $110 billion a year.
If we in turn save our $33 billion in benefit we only really save our pro rata share of those benefits.
Kyle Wingfield
November 27th, 2012
3:06 pm
JDW: But the Kaiser numbers assume all states will join. That’s where the $33B figure comes from.
stands for decibels
November 27th, 2012
3:11 pm
So tell us, master of finance, how much debt do YOU believe the world will buy from the U.S. before they stop buying?
They almost never “stop buying.” Even a horribly ravaged country with crap currency can continue to sell notes, albeit at vastly higher rates. However, I might suggest that before we start actively cutting back on stuff we need to build/people we need to insure and support, that we wait until, I dunno, maybe we have to pay, say, three whole percent on a 10 year t bill instead of 1.64%? Just a suggestion.
Or are you just full of insults with no ability to think for yourself?
Who, pray tell, have I insulted?
JDW
November 27th, 2012
3:12 pm
@Kyle…it does not matter….if the aggregate cost is $1,162 trillion, without Georgia’s participation, then Georgians incur debt/cost of $38.73 billion in cost/debt.
If on the other hand Georgia particpates and gets $33 billion in benefits then that raises the aggregate cost to $1,195 and Georgians incur debt/cost of 39.83 billion.
To pi$$ away $33 billion in benefits and save $1.2 billion is STUPID.
MANGLER
November 27th, 2012
3:19 pm
Kyle, when the Federal Government incurs debt, “we” all incur it. That’s how it works. When a State incurs debt, that’s a State debt. Georgia’s red ink doesn’t bleed over into Oregon. The Federal quill does, however. It is there to cover all States and residents – which works both ways positive and negative. The National debt would be a negative. Military and the Courts would be a positive.
So since GA will opt out of receiving a Federal Benefit which will incur a Federal Cost along with it, GA will actually have to pony up despite not having received a direct benefit.
The “big picture” concept behind this whole thing is that preventative medicine, while yes incurring large up front costs to give to everyone who doesn’t currently have any coverage, will balance out in the long run by the newly covered (along with everyone else who is currently covered but will have preventative measures now also covered) leading arguably healthier lives than they otherwise would have.
Yeah, grey area there of course, but that’s the idea. More now equals less later. The other option, less now equals more later has been tried and is how we are here.
Tiberius - pulling the tail of the left AND right when needed
November 27th, 2012
3:20 pm
To think that $33 billion in “benefits” that are unpaid for is a “benefit” is just STUPID.
southpaw
November 27th, 2012
3:21 pm
“conservatives think personal finance is identical to national finance.”
———————————
No, not really. I’d rather look at a budget with a lot fewer zeroes on it. Besides, if I try to force other people to finance my expenses (the way taxes finance government expenses), I’d rightfully be thrown into prison. But your comparison is interesting for another reason. Suppose that an individual is supposed to pay bills with his or her own money–a reasonable idea. Further suppose that a group of about 300 million people, such as the United States, doesn’t have to pay its bills with its own money. That idea seems to have a lot of support around here. Tell me, what is the “critical mass?” In other words, how many people have to band together before they no longer have to use their own money to pay their bills? Experience has already shown that the number must be between 1 and 300 million, but I’m not sure how to narrow it down any further. And don’t tell me that it’s because we’re a nation that we don’t have to pay our bills. Greece has done that for a good while, and it isn’t working so well any more. I realize that we’re nowhere near as bad off as Greece is–YET. But we will get into that same position unless we start paying our bills with our own money, not somebody else’s.
JDW
November 27th, 2012
3:22 pm
@Kyle…its actually worse than that…I did not add the $512 billion in revenue that Georgians will pay a pro rata share of….that bumps the over all numbers to $55.8 if we don’t particpate and $56.9 if we do.
JDW
November 27th, 2012
3:23 pm
@Tiberius…”To think that $33 billion in “benefits” that are unpaid for is a “benefit” is just STUPID.”
Which part of we pay at least $55.8 billion don’t you get?
Dusty
November 27th, 2012
3:24 pm
So it isn’t debt. You just have to know how to wiggle.! The state can get money by so & so & so. That’s what I gather is meant here. Is that the liberal mantra or the liberal tantrum ?
Then you don’t worry about US debts, because some nation will loan it to us..Somebody!!!
I ask you, what happned to plain old common sense? Spending more than you have builds debt but you need money. After a while, there is no one left who will loan you anything. You will be in the same state as you were on your first day on your own;, sqawling, broke, unclothed and needing a bath, not to mention a diaper.
I had rather advance a bit. I will let others enjoy that old idiom”Ignorance is bliss!” Run up your own debts, whistle in the wind, and point your finger at someone else about your begging..
Go play accountant. Let me know when you pass your CPA exam. We willl send you to Washington where, apparently, there aren’t any CPAs..
Dusty
November 27th, 2012
3:29 pm
JDW does not understand pronouns.
The pronoun “WE” means us . US with the 55.8 billion in our pockets. Yeah, right. Just small change…
stands for decibels
November 27th, 2012
3:34 pm
Yeah, right. Just small change…
Well, it’s about 170 bucks per person. Not exactly “small change” but hardly something to lose sleep over.
JDW
November 27th, 2012
3:35 pm
@Dusty..”JDW does not understand pronouns.”
I understand pronouns perfectly…we Georgians, using Kyle’s numbers and Raw Deals plan will pay $55.8 billion in taxes and debt while forgoing the $33 billion in Medicare benefits.
On the other hand we Georgians can take the $33 billion in benefits and incure $56.9 billion, again using Kyle’s numbers, in taxes and debt.
You only have two choices…which do you prefer?
JDW
November 27th, 2012
3:36 pm
@Dusty..”JDW does not understand pronouns.”
I understand pronouns perfectly…we Georgians, using Kyle’s numbers and Raw Deals plan will pay $55.8 billion in taxes and debt while forgoing the $33 billion in Medicare benefits.
On the other hand we Georgians can take the $33 billion in benefits and incur $56.9 billion, again using Kyle’s numbers, in taxes and debt.
You only have two choices…which do you prefer?
Tiberius - pulling the tail of the left AND right when needed
November 27th, 2012
3:36 pm
Being “charged” for a service and “paying” for it are two different things, JDW.
At this point, nobody is paying for anything, as this is all unfunded debt incurred. And as I stated earlier, you libs are going to run us into insolvency and crash the world economy, so our debt will be moot at some point.
JDW
November 27th, 2012
3:41 pm
@Tiberius…yeah yeah yeah…I hear your blather…now YOU have to make a decision and you only have two choices which do you prefer?
md
November 27th, 2012
3:43 pm
“Where do we find another $95.2 billion”
Best I can tell, and the last election seems to bear out……vote for the neighbor to pay it……
Sounds like the easiest way ever to finance just about anything………
stands for decibels
November 27th, 2012
3:44 pm
you libs are going to run us into insolvency and crash the world economy
(c) 1933, 1965, 2009. All rights reserved.
stands for decibels
November 27th, 2012
3:46 pm
On the other hand we Georgians can take the $33 billion in benefits and incur $56.9 billion, again using Kyle’s numbers, in taxes and debt.
You only have two choices…which do you prefer?
Well, we could “stand on principle” and allow other states to reap the benefits of having more of their residents insured which would, I assume attract more businesses and suchlike.
That’s be a lousy deal for Georgia but hey–we’d have our precious integrity intact. Or something like that.
Dusty
November 27th, 2012
3:49 pm
JDW
The whole country is already in debt. Start from there. So Feds promise to give Georgia money they don’t have. Can’t you realize that in debt means NO MONEY?
Even if the Feds had any money, after a few years they don’t plan to send any more.
Georgia has responsibly said “NO THANKS!”, a wise financial move made by wise people in Georgia. I send my thanks to them for this show of intelligence.
stands for decibels
November 27th, 2012
3:52 pm
“That’s be”? oy.
that’s be all for me for now. Later, Wingfiieldians.
Tiberius - pulling the tail of the left AND right when needed
November 27th, 2012
3:54 pm
My decision is to not incur the cost, and not pay the tax.
Problem solved.
JDW
November 27th, 2012
3:55 pm
@Dusty…”Can’t you realize that in debt means NO MONEY?”
Don’t you understand Georgians will incur 98% of the cost NO MATTER WHAT. Why on earth wouldn’t any rational person offset those costs to the best of thier ability…ooopppps rational…thats it…my bad.
JDW
November 27th, 2012
3:57 pm
@Tiberius…”My decision is to not incur the cost, and not pay the tax. Problem solved.”
Why you have all the smarts of an ostrich…
pssstttt…this is a multiple choice test there are only two answers and that is not one of them.
Don't Tread
November 27th, 2012
4:01 pm
“vote for the neighbor to pay it……Sounds like the easiest way ever to finance just about anything”
There has never been a problem that Democrats couldn’t solve using other people’s money, and now they call those “other people” greedy, racists, traitors, fascists, etc. because they don’t agree with that plan.
Tiberius - pulling the tail of the left AND right when needed
November 27th, 2012
4:03 pm
JDW, when will you realize that the “cost” of the program will NEVER be paid back, nor collected?
This is FEDERAL debt, and you libs don’t have any intention of paying it down, and the Republicans lack the will do so so.
md
November 27th, 2012
4:03 pm
“maybe we have to pay, say, three whole percent on a 10 year t bill instead of 1.64%?”
So, we would go from borrowing 262B per year to pay the debt service to 480B per year, and that is assuming we get an economy that actually does something. And if the economy stays stagnant?
There is no guarantee that we are headed for all wine and roses…….it makes much better sense to plan for water and spam and end up with wine and roses…….
JDW
November 27th, 2012
4:06 pm
@Tiberius…”when will you realize that the “cost” of the program will NEVER be paid back, nor collected?”
Oy vey…get back to me when you buy your next medical device or are subject to one of the other revenue mechanisms…well except the ones keyed to incomes of $250K and above you won’t see those.
Dusty
November 27th, 2012
4:07 pm
Having INSURANCE for healthcare does not guarantee that you will get it. Maybe! But doctors, hospitals , health workers are not happy and are not plentiful in many areas.
In socialized medicine, which is what ObamaCare is, you do not often see the doctor. You will see aids, nurses,physician’s assistants, and other workers but the doctor will be busy doing paper work so the place can be approved. Right now you can do just as well to go to a drug store with “someone” who can give you shots. That is the kind of medicine you are going to get and you asked for it. Get used to ti. .
There will always be poor people with health problems. That will not change no matter what you spend and wrecking one of the best health systems in the world to do it bides nothing good for anyone.
Tiberius - pulling the tail of the left AND right when needed
November 27th, 2012
4:12 pm
JDW, how many “medical devices” do you think are going to be bought in a recessionary economy in the next few years?
Answer: Not many.
Dusty
November 27th, 2012
4:16 pm
JDW
YOU have a problem. There is such a thing as real honest-to-goodness money.
You can float on your cloud at liberal latittudes but debt is real too because you don’t have the real money.
You’ve got NO money, honey, but keep on saying it doesn’t matter.tra la la la la la…. …
JDW
November 27th, 2012
4:20 pm
@Tiberius…”how many “medical devices” do you think are going to be bought in a recessionary economy in the next few years? Answer: Not many.”
Ah say, ah say, ah say boy…you really are a maroon….of all the recession proof markets that one might well be near the top.
Ray
November 27th, 2012
4:20 pm
What value do you put on life? An unborn embryo: priceless. A poor American: worthless, well if you are a Republican, who purports to care deeply care about the deficit. There has to be a balance; Extremists don’t see it that way. Georgia’s give aways to the wealthy (like sales tax exemptions on parts for private jet owners, or public works that specifically benefit friends and business partners reveal the true values of our Governor. It is not a pretty picture.
JamVet
November 27th, 2012
4:21 pm
…wrecking one of the best health systems in the world…
Too late. It is already wrecked.
JDW
November 27th, 2012
4:22 pm
@Dusty…”There is such a thing as real honest-to-goodness money.
Yep your choice is to spend $55.8 billion of it and get ZERO in Medicare benefits or spend $56.9 billion and recieve $33 billion…only two choices…clock is ticking…which will it be…
md
November 27th, 2012
4:25 pm
“get back to me when you buy your next medical device or are subject to one of the other revenue mechanisms”
You mean like the annual tax on providers? We’ll pay that when they add it to our premiums……
Tax on drug companies? Again, just passed along to the end user……
Cap on FSA’s? Yep, that’s our money they are capping…..more tax.
Over the counter meds? Yep, no more pre-tax dollars for those……
Tanning bed tax? Over done momma pays that one……
Additional tax on non-medical withdrawals from HSA’s…..yep, us again.
mike
November 27th, 2012
4:28 pm
“[W]ith projected cuts added in, the national security budget in fiscal 2013 will be nearly $1 trillion—a staggering enough sum that it’s worth taking a walk through the maze of the national security budget to see just where that money’s lodged.
By way of comparison, the federal government will spend around $64 billion on education that same year.”
You’ll remember that the Department of Education is one of those vile, hated departments the Right wants to do away with.
http://www.thenation.com/article/168002/how-much-does-washington-spend-defense#
Still think we can’t trim the military budget? This is a great informative article that is well worth reading.
CC
November 27th, 2012
4:28 pm
Dusty:
“There will always be poor people with health problems. That will not change no matter what you spend and wrecking one of the best health systems in the world to do it bides nothing good for anyone.”
Maybe it bodes well for systems, such as Social Security Medicare, etc.?
From the legalization of abortion to Obama’s ‘compassionate care’ of the elderly terminally ill was not a great leap. We kill the future of our country by killing the unborn, and we kill the wisdom of our country to not treating the elderly and letting them die sooner (giving terminally ill a whole new meaning!). This eases the stress on Social Security, Medicare, etc.
Aren’t we smart!
JDW
November 27th, 2012
4:29 pm
@md…yep those are some of the ones…Georgians will pay them and we should receive the benefits they entitle us to recieve…write Raw Deal let him know how you feel.
Dusty
November 27th, 2012
4:29 pm
Jamvet.
You are one silly man. Just because you see everything in blue & purple doom & gloom does not mean it is true.
The USA is well known world wide for its great healthcare. Those who can afford to travel here are right in our hospitals as soon as they can get here.
Too bad you cannot appreciate the greatness that is the USA in so many fields of endeavor. .
CC
November 27th, 2012
4:31 pm
“Too late. It is already wrecked.”
Yep, effective as of the date of passage of NobamaCare.
Tiberius - pulling the tail of the left AND right when needed
November 27th, 2012
4:31 pm
JDW obviously doesn’t understand the retrenchment theory of economics.
EVERY market will be affected by the coming recession. And “new” medical devices will be affected just as much as anything else, because there is a cost/benefit reality to expensive new equipment that provides marginal improvements over existing ones.
Kyle Wingfield
November 27th, 2012
4:32 pm
mike @ 4:28: And how much do the states spend on education compared to defense?
It’s called federalism.
Linda
November 27th, 2012
4:33 pm
No one has honestly answered Kyle’s question. A few liberals are beginning to realize that Obama’s plan to tax millionaires & billionaires is nothing more than a pipe dream, a drop in an ocean.
The Democrats’ intention is to allow the tax cuts to expire on all tax brackets, but they will still be trillions of dollars short.
The answer to Kyle’s question is: there is NO PLAN to pay for either the old spending or the new spending or the debt or the unfunded liabilities.
We are doomed.
Dusty
November 27th, 2012
4:36 pm
911 get help for JDW
He has no concept of the meaning of zero That is 00000000000, the amount of money you DO NOT HAVE when you are in debt.