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
md
November 27th, 2012
7:42 pm
They treat you like dirt because the feds have been lowering the re-reimbursement rates steadily for decades……and the folks that want obamacare won’t know what hit them……docs/hospitals/nursing homes all know who is paying the freight, and it is their private pays….the system is about to get even worse with all the new medicaid rejections, watch as the docs bail from the system.
Linda
November 27th, 2012
7:44 pm
mike(with a little m)@7:27, You are confusing Iraq & Afghanistan with our oil interests. The US has been spending an average of $50 B per year for decades protecting our oil interests in the Middle East, which has amounted to TRILLIONS of dollars. The entire world is laughing at us.
http://online.wsj.com/article/SB10001424052702304441404577480952719124264.html
The problem is that Obama & the Democrats are allergic to fossil fuels & have waged a war on them. The Obamamobiles will not sustain us for many years to come, especially since consumers hate them. We are a Ford truck nation.
Hillbilly D
November 27th, 2012
7:50 pm
We are a Ford truck nation.
Only thing you can put a load on, as George used to say.
Hopeful
November 27th, 2012
8:04 pm
People are hungry and starving here also and are Americans! We need to help the red white and blue as well as the Different countries has any other Nationality ever help you out of their heart???
carlosgvv
November 27th, 2012
8:10 pm
Chessy – 6:35
Soldiers can be in a fire fight and run out of ammo. The lieutenant then will yell out “fixed bayonets”. If the enemy also runs out of ammo at the same time, you may be sure they will come after you with their bayonets. Youe own rifle with bayonet is what will save your life.
It’s virtually certain a rich kid like you wouldn’t be caught dead anywhere near a military recruiting office. Still, you spout off about military and other matters as though you’re an expert.
You’re only fooling the ignorant here, sporty.
yuzeyurbrane
November 27th, 2012
8:22 pm
Kyle, you are just incorrect in your “facts”. Obamacare includes financing provisions which actually not only make it financially sustainable but reduce the budget deficit as compared to doing nothing, per the Congressional Budget Office’s neutral scoring. Also, there seems to be price estimate creep at the AJC. Its articles have variously cited a cost to Georgia of $1.8 billion, $2.2 billion and now your $2.5 billion. Gov. Deal’s spokesman estimated over $4 billion based on their general experience of what happens to these type programs. Now, that is faith-based on the right’s alternative universe. As to the value of the Fed. input I have seen your $33 billion and others significantly higher, especially when factoring in the multiplier effect in the economy and new state tax revenues they would generate. Kyle, explain to me. I’m willing to listen. But I think its just arithmetic and I observe that your college major was journalism, not math.
Hopeful
November 27th, 2012
8:27 pm
Dose anyone care about the men at war their children and wife’s ?????
Terry Bradshaw
November 27th, 2012
8:40 pm
I had a educated Liberal tell me “that all the Government has to do is print more money!” With this mentality & being qualified to vote………. we are all doomed!
Jack ®
November 27th, 2012
8:47 pm
Mr. W, didn’t you know that Obama can pull a rabbit out of a high-hat? Didn’t you know that he can wave his little old wand and money will appear right before your very eyes? The man is a magician.
ODD OWL
November 27th, 2012
9:06 pm
Nathan Deal is a ideologically tainted, tea party Republican… He rejected $14 billion dollars in Federal funds to set up ObamaCare healthcare exchanges and to cover medicaid expansion… The Georgia Republican Congressional delegation rejected Democrat stimulus money to fix roads and rebuild the infrustructure.. Sonny Perdue stole $1 billion dollars from the highway repair fund and gave it to the rich and elite as tax cuts.. Now Georgia state roads are deteriorating, but instead of repaving the entire road with asphalt, the Republicans are patching them with rough gravel, the way they did back in the ’50’s… Deal no deal and the Republicans who control the state legislature are naive, gullible, bloviating ignoramuses… Democrats make up 49% of the population of Georgia and we will not allow these sucessionist Republicans to drag our mordern lifestyle back into the 1840’s…
Del
November 27th, 2012
9:39 pm
“Or do they think Georgia taxpayers will truly believe someone else will handle that federal portion of the cost?”
Kyle, of course they think so, liberals are programmed to believe that taxing high income earners is the solution to every federal government spending program.
Dr Who
November 27th, 2012
9:42 pm
“watch as the docs bail from the system.”
When is this going to start? Are med school applications down or up across the country?
Dr Who
November 27th, 2012
9:46 pm
Del
Are tax rates higher or lower than they have been in the last 50yrs? That is for individual and corporate rates?
Dr Who
November 27th, 2012
9:53 pm
Del
Speaking of “programmed to believe”; you seem to be nothing more than a right wing, walking and talking point.
nelson
November 27th, 2012
9:56 pm
I was one of the first recipients when medicaid first was enacted. went to the dentist for a filling. When he saw the medicaid card he said why have a filling when you can have a crown. That was gold. I knew then, what everyone knows now, it is a force in bankrupting the country.
Dr Who
November 27th, 2012
10:01 pm
nelson
So was that the dentist’s deception and fraud or the government?
Did you agree to it and assist in defrauding the government?
the red herring
November 27th, 2012
10:10 pm
obama has 6 trillion in debt in 4 years—figure adding that much more in the next 4. how long do you think china will pay for our healthcare. how long before our money is worthless? how long before interest begins to climb and all this costs much, much more? we need to get back to basics, live within our means and let those who want insurance get a job and go out and buy it. obama’s plan is give free stuff to enough people and they will vote your way—it worked. the taxpayers will pay for it dearly. sad state of affairs for this country but the upcoming depression will change some peoples minds—i believe we will see similar riots to those in greece. once the free feed trough dries up there will be chaos. those of us clinging to our guns and liberties will be the only ones safe.
Dr Who
November 27th, 2012
10:15 pm
red herring
You are funny. Since you think it is all doom and gloom, don’t do anything drastic and put yourself 6′ under.
Lil' Barry Bailout - OBAMAPHONE!!!
November 27th, 2012
10:17 pm
jconservative: We have made some progress on deficit/debt in the last couple of years.
—————–
Oh? How does Obozo having increased federal spending by $500 billion per year constitute “progress” on deficit/debt?
md
November 27th, 2012
10:25 pm
“When is this going to start? Are med school applications down or up across the country?”
Started years ago……no reason to believe it won’t get worse as the medicaid rolls swell. We have plenty of docs, but they do not all service medicare/caid patients. It is medicaid that will be expanding due to obamacare and medicare due to baby boomers……
And as I said, it is due to the ever increasing reductions in reimbursement rates. It is an illusion that makes it look as if the gov’t is holding down costs to providers when in actuality those providers just jack up the fees on everyone else to make up the difference.
Dr Who
November 27th, 2012
10:32 pm
md
Within 10 yrs we will be headed to single payer. The hard left wants to thank the right for fighting Obamacare every step of the way. Obamacare is nothing but a treasure chest for the insurance companies.
I’m not a single payer guy but the right is going to wish that they had worked better on this issue when they had Bush and a Republican Congress.
Lil' Barry Bailout - OBAMAPHONE!!!
November 27th, 2012
10:35 pm
Perhaps someone can explain how the Messiah’s most excellent health care plan, sure to be a huge, deficit-reducing success, will result in single payer.
ScottNATL
November 27th, 2012
10:44 pm
First…the governments money doesn’t come from taxes…they print it…called fiat currency…so all this talk about the debt is a bunch of bs in the long run (and before anyone starts on the inflation train…show me the inflation…the Fed has been trying to raise capitol levels for a couple of years already…but very little if any inflation) 600,000 Georgians might not agree with the governor when election time comes around again since that would be about the number left without insurance. I guess the Mitt emergency room is going to be their primary care giver (at aprox 30x the cost)
Alter Ego
November 27th, 2012
10:45 pm
Obamacare is front loaded. The real costs come down the road, beyond FY 2016, when the emphasis shifts from preventative to more expensive care. It doesn’t matter that the Feds pay 90% of it when the real dollar cost will escalate. As a governor, Deal and the other state leaders are doing exactly the right thing in not rushing to embrace what could become an unsustainable burden for the state.
Kyle also neglected to mention SSDI. Over 5.4 MM have been added to the roles under Obama’s first term, with an average age of 49, and 99% who never return to the workforce. SSDI enrollees can qualify for it in two years, and the growth trends are unsustainable.
Elections Have Consequences
November 27th, 2012
10:48 pm
@Lil’ Barry Bailout
Sure-by eliminating the competition-just like everything works in Chicago politics..
Alter Ego
November 27th, 2012
10:49 pm
@ScottNATL – Been to the grocery store lately?
An Observer
November 27th, 2012
10:51 pm
I am proud of governor Deal, and I hope he does not change his mind. We cannot bankrupt Georgia on a whim of Washington and their love of deficit spending.
Hopeful
November 27th, 2012
10:53 pm
Enter your comments here
Hey maybe Clark Howard should run would anyone voted for him I would
Hopeful
November 27th, 2012
11:12 pm
We would all have green houses
yuzeyurbrane
November 27th, 2012
11:36 pm
To those of you who say MD’s will not participate in Medicaid or Medicare, you are oversimplifying the facts. Medicaid patients continue to get care even though the pay rate for docs is much lower than Medicare. The statistics presently show most docs accepting Medicare. It varies among specialties. A hip or knee surgeon cannot afford to exclude Medicare patients. A sports medicine specialist might be able to do without older patients. Before Medicare, docs made respectable upper middle class incomes; now they are often millionaires. Those who are attracted to medicine as a road to riches may instead become stockbrokers; those remaining may be more loyal to altruistic urges, like they used to be, and be satisfied with an upper middle class lifestyle. Medical schools are packed so there is no evidence that prospective doctors are being deterred by a fear of Obamacare or Medicare. The truth is the path to bringing medical costs under control is to weed out the greedy. Dr. Tom Price doesn’t like this for obvious reasons.
Mike C.
November 28th, 2012
12:58 am
Whole point of Obamacare is moot for now.
There is currently a lawsuite meandering through the courts which has to do with the fact that Obamacare originated in the Senate and not the House (as the law requires all tax and spending bills).
Since it did not originate in the House, the law is illegal.
Until that is resolved, everything else is a non argument.
Buzzy
November 28th, 2012
1:10 am
The Republican cult just can’t let “Obamacare” go, can they? No matter how pathetic this continued whining makes them look, they just can’t let it go.
Wake up folks, the President won handily. People didn’t fall for your attempt to bash Obamacare.
Let it go.
ODD OWL
November 28th, 2012
1:46 am
Georgia is aready a bankrupted, welfare state… Gov. No Deal will be forced by the Feds. to accept ObamaCare/Medicaid money or he will be forced to stand down and a Federal administrator will be sent in to administer all state and local business… China hold only 7% of America’s debt… 75% of our debt is held by Americans…The Bush/Cheney Republicans dumped $11 trillion dollars worth of debt into the lap of President Obama and the Democrats, add to that $2 trillion in interest = $13 trillion dollars of Republican debt… President Obama added only $3 trillion dollars to the national debt… The President has actually paid down the debt by $1 trillion and the yearly deficit by $300 billion… Greece invested their social security and pension money in the stock market… They purchased mortgage derivative bonds from American banks… Now suppose the American people had been stupid enough to listen to that ignoramus Bush and allowed him to invest our social security money in the stock market… America would be Greece on steroids today… “News Alert” The corporate bosses are ripping off their employees with these 401-K retirement accounts… The average amount of money an employee have in their 401-K account when they retire is a puny $80.000… A Union pension fund is the safest place to put your retirement money…
ODD OWL
November 28th, 2012
1:56 am
The stock market crash every ten years or there about… When the stock market goes up, so do your 401-K… when the stock market goes down, your 401-K goes down and you must start all over again… The 401-K is a catch-22 vicious circle…
Joel Edge
November 28th, 2012
6:09 am
Even the locals where I live talk about money from the feds like it’s money that drops from the sky. Oye!!
Tiberius - pulling the tail of the left AND right when needed
November 28th, 2012
6:56 am
“Gov. No Deal will be forced by the Feds. to accept ObamaCare/Medicaid money or he will be forced to stand down and a Federal administrator will be sent in to administer all state and local business”
This is the kind of dictatorship people on the left really desire. Do as we say, or else.
It’s all about CONTROL with these people.
Attack Dog
November 28th, 2012
8:11 am
How does the Dixiecancare plan address the following issues? 1. What to do about the $49 billion in medical bills of the uninsured annually? 2. What to do about paying for the $100 billion annually for the underinsured? 3. What to do about paying for people who are underpaid at places at Wal-Mart, just so that they can go on Mediaid? 4. What to do about paying for medical over diagnosis? 5. What to do about fraud? 6. What to do about insurance companies raising rates by 20% and now we have an average annual cost of “medical insurance” exceeding $15,000 per person? 7. What to do about insuring insurance companies spend the most of our premiums on health? 8. How do we cover economic impact of people going bankrupt because of health care costs?
1961_Xer
November 28th, 2012
8:36 am
JDW writes: @1961X_er…”In socialized medicine, which is what ObamaCare is”
Wrong attribution. I never called ObamaCare “socialized medicine”. It is more like “socialized insurance” than socialized medicine.
md
November 28th, 2012
8:45 am
Just call it what it is…..socialized medicine. Socializing the payment method IS socialized medicine, regardless how the payment gets there.
Madmax
November 28th, 2012
9:04 am
Kyle,
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?
They will just print more money and/or confiscate more money from the private sector because it’s the “right thing to do” and blame Bush/tax cuts/war/the right for being obstructionist and the cause of all ills that befall us – not a problem to our left brain thinkers.
Lil' Barry Bailout - OBAMAPHONE!!!
November 28th, 2012
9:10 am
When will Obozo show us his plan for avoiding the fiscal cliff?
Madmax
November 28th, 2012
9:12 am
Barry – you already know his plan – blame Bush/Republicans and go on a speaking tour.
JDW
November 28th, 2012
9:35 am
@md…”Just call it what it is…..socialized medicine. Socializing the payment method IS socialized medicine, regardless how the payment gets there.”
If you are going to toss word around you need to understand the meaning and I think you need a basic definition…
Socialized-To place under government or group ownership or control.
NOTHING about Obamacare places healthcare under government or group ownership or control. The act simply makes it a requirement that people own PRIVATE health insurance and SUBSIDIZES (note the proper word) that purchase for those with lower incomes. The government has taken no control of the mechanisms of delivering health care and other than creating payment standards for Medicare, as does EVERY insurance provider, exerts no control over pricing.
CC
November 28th, 2012
9:55 am
“NOTHING about Obamacare places healthcare under government or group ownership or control.”
I hereby place this statement into nomination as the “dumbest statement of the year”!
JDW
November 28th, 2012
9:56 am
@CC…what part is it about PRIVATE INSURANCE that you don’t understand?
md
November 28th, 2012
10:12 am
JDW…..you are fooling no one but yourself.
Paying for subsidies and expanding the rolls of medicaid by forcing others to pay for it is basic socialism…….you can wordsmith all day and night and the underlying principal does not change.
breckenridge
November 28th, 2012
10:14 am
As a nation we need to make a concerted effort to stop Medicaid growth. 40% of kids born in America today are born to parents or a parent on Medicaid. That’s why, as a fiscal conservative, I’m call on the republican party to promote strong pro-birth control, pro-abortion policies for couples and singles who cannot afford to raise children without help from taxpayers.
md
November 28th, 2012
10:16 am
“Socialized-To place under government or group ownership or control”
And what do you think they did?
A gov’t mandate/tax IS gov’t control……….
md
November 28th, 2012
10:18 am
“40% of kids born in America today are born to parents or a parent on Medicaid.”
I think the question then becomes how many are unwanted……if it’s a small percent, then the solution is not providing birth control, the problem would still exist.
Linda
November 28th, 2012
10:25 am
ODD@1:46, You can’t spread lies on a conservative blog without being exposed for what you are.
$4.899 was added to the natl. debt in 8 yrs. of the Bush adm.
$5.7 T has been added to the natl. debt in less than 4 yrs. of the Obama adm.
Since the natl. debt was $5.728 T when Bush was elected, Obama has actually doubled the entire debt of the US than was racked up under the first 42 presidents.
Interest is not in a separate debt account.
Obama has not paid down a cent of the debt & his annual deficits have exceeded over $1 T each & every year.