Sorting out the ‘we’ in Medicaid expansionists’ claims
When someone tells me I can get something of value for “free,” I raise an eyebrow. When that “free” thing is coming from the government — and worth billions — I reach for my wallet.
So it goes with the question of whether Georgia should opt into Obamacare’s expansion of Medicaid.
In upholding most of the health reform law this summer, the U.S. Supreme Court did allow one concession to the states that sued to overturn it. The court ruled Washington could not threaten to take away states’ existing Medicaid funding if they declined to expand Medicaid. Each state must now decide whether to take part in the expansion and make anyone earning 138 percent of the federal poverty level eligible for Medicaid.
Georgia Gov. Nathan Deal in August said he would decline the offer on two grounds. First, the state can’t afford its share of the expansion’s cost. Second, Deal doesn’t believe a heavily indebted Washington will uphold its end of the bargain, possibly putting the state on the hook for even more than projected. Medicaid already accounts for more than $2 billion in state spending each year, or almost $1 of every $7 from the state’s general fund — and rising.
There’s no sign Deal is wavering on this decision, but Obamacare supporters keep making their case to the public.
They scarcely try to convince us the state’s portion of the expansion is affordable — though they do argue the state’s projection of $4.5 billion over 10 years is too high.
Instead, they focus on the federal money Georgia will forgo if we don’t participate. A recent study by the Kaiser Family Foundation, reported in the AJC this week, put the figure at $33 billion over the next decade. This, proponents say, is a matter of getting what’s due to us.
The gist of one of their key arguments is: We are going to pay the taxes levied by Obamacare, so we at least ought to get the funding it’s meant to provide us.
This argument assumes Obamacare will actually pay for itself, a dubious proposition given Washington’s history of missing high on revenue forecasts and low on cost projections. But that’s not my point today.
Instead, I want to point out that “we” isn’t always we. Sometimes “we” is they.
In the above example, the payers of the tax are indeed “we.” But “we” are not the beneficiaries. The beneficiaries are the health providers, mostly hospitals, who have their eyes on that $33 billion.
New Medicaid enrollees would gain some benefit, though even that’s limited because the number of doctors who don’t accept new Medicaid patients is large and growing. But many of these potential enrollees already receive care that simply isn’t paid for.
While no one’s calling this a hospital-bailout program, that’s what it boils down to.
But aren’t we already paying for these patients? What about that “care that simply isn’t paid for”?
Yes, we’re already paying for them, in part via higher insurance premiums. But not as much as you think: A study by the Urban Institute found uncompensated care accounts for just 1.7 percent of health premiums. The Medicaid expansion would reduce this by only a fraction. The Obama administration itself has said the Medicaid expansion would reduce the “cost-shifting” from the uninsured to the insured by just $1 billion a year – nationwide.
Compare that $1 billion a year in savings to the estimated $95 billion a year Obamacare would spend to expand Medicaid.
The reduction of cost-shifting may be smaller than one might expect because Medicaid payments often don’t cover the cost of treatment, which explains why so many doctors don’t accept new Medicaid patients. When you lose money on every patient, you can’t make it up in volume.
So don’t expect the Medicaid expansion to lead to smaller premiums in your private insurance. History tells us the opposite will happen. Expanding a broken program is of no real help to the uninsured or to taxpayers.
Perversely, the states that decline to expand their Medicaid programs may actually make Obamacare more sustainable by lowering its costs. But it should keep pressure on Washington to come up with real reform that benefits the uninsured and our health system more broadly.
– By Kyle Wingfield
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247 comments Add your comment
Tiberius - pulling the tail of the left AND right when needed
November 29th, 2012
1:22 pm
“And, thanks to global warming, we’re geting even warmer every year.”
And yet the warming is leveling off (and possibly cooling depending on which data you believe), despite NO programs in place to curb it, and no slowdown in the expansion of mankind.
Which is why I remain skeptical about the CAUSE of global warming, even if YOU buy into it hook, line and sinker, carlos.
JDW
November 29th, 2012
1:30 pm
@Tiberuis..”the growth in this area during the dates you cite was spurred by a growing economy ”
Indeed, one that has come to a screeching halt as the Republican disaster continues to unfold in this state.
“You’ll also notice that the fastest-growing county in the state (and in the top 5 in the country) during that time was Forsyth county, which isn’t even in the 10-county metro area.”
Of course Forsyth does’t benefit at all from the Metro Area does it
“consult with those of us who do”
If I ever need to know how things are in Tiberuisville I will ask…until then I will stick with sources that that have a bit more on the ball.
DawgDad
November 29th, 2012
1:38 pm
“an addition to Mount Rushmore so that it can be unveiled the day before President Clinton is inaugurated. I think that would be a fitting tribute to BHO.”
Would expect no less from the left and the American voters. BHO already has a Nobel Peace Prize, nothing can really top that for utter absurdity.
Oh well
November 29th, 2012
1:43 pm
“nothing can really top that for utter absurdity.”
Well except for thinking Romney was going to win because Fox and radio pundits kept saying it was going to happen I would agree 100%
yuzeyurbrane
November 29th, 2012
1:47 pm
Too bad Gov. Deal rained on your parade by announcing support of state funding for new Falcons pleasure palace on the same day as your article denouncing state expenditures on healthcare for the working poor. By the way, CMS (Center for Medicare & Medicaid Studies) has stated that states that expand Medicaid to working poor can opt out of Medicaid expansion later if they change their minds. So what is the harm in at least trying for first 3 years when the Feds pay 100% to see how the numbers actually work out?
Don't Tread
November 29th, 2012
2:04 pm
“BHO already has a Nobel Peace Prize, nothing can really top that for utter absurdity.”
Well they gave it to Arafat, as I recall…About the same I suppose.
And adding 0bama to Mount Rushmore is about the dumbest thing I’ve ever heard of – it would be more appropriate to put a big poster of his face next to the national debt clock.
carlosgvv
November 29th, 2012
2:08 pm
Tiberius
Read the WHOLE article, boobie.
http://www.examiner.com/article/global-warming-has-stalled-but-2012-on-track-to-be-ninth-hottest-year-globally
stands for decibels
November 29th, 2012
2:16 pm
When someone tells me I can get something of value for “free,” I raise an eyebrow. When that “free” thing is coming from the government — and worth billions — I reach for my wallet.
I’m going to second “Glenn Beck” and his post @ 9.39. I do not recall anyone in an official capacity or otherwise, claiming that the funds for expanding Medicaid were free.
I say this because I think otherwise this is a perfectly respectable case you’re making. It would be a lot better if you didn’t lead with a straw man.
(I don’t agree with it–I think expanding the Medicaid safety net and getting more low income people into health insurance plans is worth it, however it’s funded.)
stands for decibels
November 29th, 2012
2:17 pm
And yet the warming is leveling off
I genuinely pity you.
JDW
November 29th, 2012
2:20 pm
@Tiberius…”Which is why I remain skeptical about the CAUSE of global warming, ”
Funny, thats just how it works when you boil a frog…they remain skeptical right up until the end.
There are only four choices you dufus…you should always pick one that you can impact and always avoid the worst option…ie bad things.
–Global warming won’t hurt us so we do nothing no harm no foul
–Global warming won’t hurt us but we cut emissions anyway causing no harm.
–Global warming will hurt us and we do nothing leading to bad things
–Global warming will hurt us and we do something saving ourselves.
stands for decibels
November 29th, 2012
2:21 pm
Paul Ryan thinking he ran a sub-3 hour marathon when in fact it was just barely sub-4 is arguably more absurd
not that anyone asked, but I’ve shifted my position on that one. I am now inclined to believe that he might well have just grabbed the number out of thin air, not remembering what his time was and thus grasping for what he thought a decent time might be (as he has claimed.)
It was very hard to believe when I first heard of it, because anyone who’s trained for and run a marathon in middle age knows it is bloody difficult. But if you do it one time, kind of as a lark, as a young man, which Ryan was a the time–you could conceivably let the overall time slip down the memory hole.
stands for decibels
November 29th, 2012
2:35 pm
John Q @ 2.24, I had to go back and check (I obviously wasn’t following this little sideshow THAT closely) but what he said was “2 hour and 50-something”. I really think he might’ve been thinking about what he had likely been shooting for 22 years ago, which might’ve been 3h50m-ish.
Believe me, I am NOT typically inclined to give Paul Ryan the benefit of the doubt on most things, but this, kinda like Obama saying “Over the last 15 months, we’ve traveled to every corner of the United States. I’ve now been in 57 states? I think one left to go. Alaska and Hawaii”–I think that was just a slip, nothing more to see here.
Oh well
November 29th, 2012
2:48 pm
John Q
Either way, Romney and Ryan were delivered an Electoral College whipping.
Ryan did win his seat, but didn’t help carry his state or even his district.
stands for decibels
November 29th, 2012
2:51 pm
if herr ryan is the genius numbers wonk everyone alleges him to be, i’d venture to say it was a deliberate lie.
heh. well see… he is not a genius numbers wonk. There’s the rub. The idea that you could voucherize Medicare as he’d attempted to legislate, without massive economic disruption–that sort of thing does not come from a “genius.” It comes from a paid-for hack.
Bye Bye Cheesy Grits
November 29th, 2012
3:02 pm
And adding 0bama to Mount Rushmore is about the dumbest thing I’ve ever heard of – it would be more appropriate to put a big poster of his face next to the national debt clock.
Right beside Ronald Reagan’s.
After all he quadrupled the debt in just 8 years.
Obama hasnt come close to that.
Dusty
November 29th, 2012
3:02 pm
Same old stuff here. Any script writer could do the whole thing from memory every day.
LIberals refuse to believe that a DEBT means lack of money. Neither the state governments or the Federal government are out of debt meaning there is no money available.
Governor Deal knows that. President Obama does not.
You can talk about poor people, sick people, Reagan, Bush, climate, Emtala, Romney, population statistics, KKK, Black Panthers, religion, cheesy grits, schools, hospitals, my sick one,repayment,,and any other distractions.
One fact remains; the country and the state are deep in debt.
We need to cut spending and take less from taxpayers to live on.. ObamaCare increases spending. Medicaid increases spending. The “gravy train” moves on. The debt moves up. Both must “brake” before a catastrophic crash occurs as it did around 1929
Oh well
November 29th, 2012
3:08 pm
“Same old stuff here. Any script writer could do the whole thing from memory every day. ”
Yes, you and other righty bloggers are still crying. Same “ole stuff” and “same ole” deflections and excuses.
You betcha
MarkV
November 29th, 2012
3:08 pm
Kyle is using a whole bunch of convoluted, false arguments and statements. They start immediately as he starts:
“When someone tells me I can get something of value for “free,” I raise an eyebrow. When that “free” thing is coming from the government — and worth billions — I reach for my wallet.”
So my first question to Kyle is: Who has said anything about the Obamacare’s expansion of Medicaid being “free” money from the government? If someone did, Kyle you correct that person, and not make it the subject of his article as if nobody understood that all the money the government uses comes from people.
But the most ridiculous argument Kyle has made is the following:
“In the above example, the payers of the tax are indeed “we.” But “we” are not the beneficiaries. The beneficiaries are the health providers, mostly hospitals…”
So, according to Kyle, the money will just go to hospitals and health providers, “who have their eyes on that $33 billion.” Really? They will just grab the money and spend it on mansions and cars and yachts? They will not treat people?
“What about that “care that simply isn’t paid for”? Yes, we’re already paying for them, in part via higher insurance premiums. But not as much as you think.”
Then who is paying for the care, Kyle? Why don’t you tell us? Perhaps you can repeat the infamous Dusty’s argument that the hospitals just “have it in their budget?”
MarkV
November 29th, 2012
3:11 pm
“Medicaid increases spending.”
What a profound revelation. People get treated, and it costs money. Who would have thought that?
Don't Tread
November 29th, 2012
3:23 pm
But Dusty…taking less from the taxpayers would mean they’d have to give up the goal of “equality of results”, and we just can’t have that. Instead, they float around the idea of a “wealth tax” in addition to income taxes, carbon credits, and all the other schemes they can think of to separate productive people and their money.
JohnS
November 29th, 2012
3:26 pm
Deal has no problem finding half a billion dollars for a stadium for one of his republican buddies though.
curious
November 29th, 2012
3:42 pm
Don’t worry.
Gov Deal will embrace an expansion of Medicaid as soon as he figures a way to profit from it.
Oh well
November 29th, 2012
3:44 pm
“Gov Deal will embrace an expansion of Medicaid as soon as he figures a way to profit from it.”
Sort of like the new stadium he was against just a few weeks ago.
stands for decibels
November 29th, 2012
3:45 pm
Same old stuff here.
Come on, Dusty. I mildly defended Paul Ryan’s character. That doesn’t happen every day.
stands for decibels
November 29th, 2012
3:46 pm
the goal of “equality of results”
Feel free to cite the elected Democratic officials of the past, oh, twenty years, who have advocated that as their goal.
Dusty
November 29th, 2012
4:08 pm
OH well, here’s a little something paraphrased from the writings of Pastor Niemoller. I call mine
DOLLARS UNBOUND ( if Shelley will forgive me for that title)
First they took my dollars for Social Security
and I did not speak out
because one gets old.
Then they took my dollars for Medicare
and I did not speak out
because one gets sick
Then they took my dollars for medicine
and I did not speak out
because there is pain.
Then they wanted my dolllars for ObamaCare
and I did not speak out
because there was nothing left to give.
.
.
GB101
November 29th, 2012
4:12 pm
Oh well
Yes, the population grew in the country as a whole. In my lifetime it doubled. In Ga it nearly tripled, as I said. Ga was a small state when I was born, now it is among the largest. Like I said, if this place is such a hell hole it does seem odd that so many people want to move here.
Oh well
November 29th, 2012
4:15 pm
GB
Good point. Same can be said for the US and the crying folks do about the election.
GB101
November 29th, 2012
4:16 pm
JDW
The article you cite is not about Ga’s growth but Atlanta’s. And it is only about the municipality of Atlanta, not the metro area. The city proper has only about 10-15% of the metro population.
Oh well
November 29th, 2012
4:17 pm
Dusty
Were you not the one speaking of Deal and congratulating him a few weeks ago in regards to his “stance” against a new stadium?
Apologies if it was not you. If so, have you read about his change of heart?
____________________
As for your poem. Originality; F
But keep trying and bless your heart
Thomas Heyward Jr
November 29th, 2012
4:17 pm
“But it should keep pressure on Washington to come up with real reform that benefits the uninsured and our health system more broadly.”
.
Remember this………….when a person mentions “reform” and “Washington” in the same sentence……. you are talking the language of the deviants in Washington.
.
Beware.
Kyle’s already gone over to the dark side.
.
lol
Oh well
November 29th, 2012
4:21 pm
“The city proper has only about 10-15% of the metro population.”
True, but you fail to mention like most other cities in the country; the metro areas grew because folks were coming to the Atlanta metro area, LA metro area, etc.
Most people in the country couldn’t tell you about the burbs of most other major cities, unless they lived there or do business there, but they know about the major city.
I would agree that Atlanta has grown so much that many come to the area and never go to Atlanta proper, but they still use the airport when needed, etc.
pogo
November 29th, 2012
4:22 pm
The house of cards that the democrats have made for themselves is going to fall apart. They celebrate their victory today but in just a short amount of time they will lamenting the day they ever heard the name Obama. When he can no longer hide behind the Feds money printing machines and the real bills come due, he may or may not be in office but one thing is for certain; he will be blamed. History has a way of exposing the frauds and make no mistake, Obama is a fraud. When I hear that some 60% of the people between 18 and 29 years old (and even a larger number for blacks) are OK with socialism, you know that we are in deep, deep trouble. What we now have is a society that is spoiled rotten and that are used to getting what they want at no cost to themselves (they think). But that will change. In the Great Depression if you did not work you did not eat. Now, you can eat and still not work. There is a reason for that. It is called deficit spending, something most of Obama’s base doesn’t understand (because of their literacy rate) and can’t comprehend and ultimately, they couldn’t care less if he country went down the tubes. Just as long as the checks and the SNAPS cards keep coming.
GB101
November 29th, 2012
4:24 pm
Bye Bye Cheesy Grits
Georgia’s growth is not attributable to the high rate of teen age pregnancy. And as long as you are comparing Ga to Mass, our population is 30% black; Ma’s is about 7. About 70 % of black children are born to unwed mothers (this is not the same as teen mothers, but the two things are related. So when you say the Ga’s teen age pregnancy rate is higher than Ma’s you are in effect saying Ga’s black population is higher than Ma’s.
OK, I am ready. Call me a racist.
Oh well
November 29th, 2012
4:25 pm
pogo
Sam crap, different blog for you
Oh well
November 29th, 2012
4:29 pm
pogo
Why no mention of deficit spending by Republican WHs and Congresses? Guess it doesn’t fit your narrow minded narrative.
It is a two way street if you have an inkling of intellectual honesty and knowledge.
Oh well
November 29th, 2012
4:35 pm
GB
While not the same percentage as blacks, is there as reason you didn’t mention that white unwed mothers is growing?
carlosgvv
November 29th, 2012
4:55 pm
Dusty
The writeings of that pastor reflect on of the worst times in humam history.
To paraphrase it for purposes of a cheap political shot against Obama only shows how dirt common and base you truly are.
Dusty
November 29th, 2012
4:59 pm
Oh Well, do tell
I did like to hear that the governor was against a new stadium. So he changed. Happens. Must have gotten some new info on the cost & profit. He will let us know
I am also glad he knows the state is in debt and does not need any more Setting up a new unproven healthcare system while in debt is not a good idea. The governor knows that
He also knows that the Federal government is 16 trillion$ in debt.
Did you notice that the KIA plant in Georgia is going to enlarge its huge complex. More jobs! Now that is the way to get out of debt. Our governor knows that too. .
The U
November 29th, 2012
5:00 pm
What everyone fails to realize is that we are going to be paying for it, regardless. Georgians and all the folks in the other states that decline to participate in the expansion will still continue to pay federal income taxes. Those tax collections will then be used to subsidize the expansion of the programs in all those states that will be participating. How is that good for the citizens of GA? We pay but receive none of the benefits. What a deal for the states that are expanding!
Oh well
November 29th, 2012
5:14 pm
Dusty
You will buy what ever he is selling, what is new?
Only fools thought he was actually against the stadium. That is the kind of things that politicians feed people like you……… because you are gullible and willingly ate and will eat it up.
There was always going to be a new stadium.
But don’t fret, the left has as many sheep in their flock as the right does in theirs.
Tiberius - pulling the tail of the left AND right
November 29th, 2012
5:18 pm
I see we have a new sock puppet in the Black Label / Sunny/ John Q group.
Welcome, Oh Well. (whoever you are)
md
November 29th, 2012
5:21 pm
I keep reading about why the money should be spent, but what I don’t see is what those in favor would like to cut in exchange…..or are tax increases the order of the day?
Ga IS a balanced budget state, they can’t play the same game the feds do by kicking the can down the road……
Tiberius - pulling the tail of the left AND right
November 29th, 2012
5:22 pm
And JDW,your ignorance about what caused the housing bubble and why it burst knows no bounds.
Oh well
November 29th, 2012
5:22 pm
Tiberius
And who are you? Should that be a concern (I doubt it very much) of anyone including myself?
Oh well
November 29th, 2012
5:25 pm
“or are tax increases the order of the day?”
Well in GA they call it “fee increases” and not tax increases and didn’t Perdue change something regarding deductions for interests on your home?
Dusty
November 29th, 2012
5:27 pm
Carlos, re Pastor Niemoller’s writings
I do know he referenced one of the world’s greatest human tragedies, the Holocaust. We sorrow still.
He also showed the process that often leads to human disasters. That process includes the fact that people do not object/speak out when they think something is wrong. On a much lower scale of human disasters, throwing millions of people in greater debt does not rank near the top. But it does affect millions as we see in Greece, Spain and Portugal.
I speak about President Obama’s POLICIES that I think endanger this country. I will continiue to do so. ObamaCare is expensive, unproven ,incomplete and probably not effective. I will mention that as long as I see it and we have free speech.
In other words, if you don’t like what I write, just grin & bear it. And complain, too, of course!!
Oh well
November 29th, 2012
5:28 pm
“In other words, if you don’t like what I write, just grin & bear it. And complain, too, of course!!”
Like wise, yet it doesn’t stop you from crying and complaining
Just saying
Tiberius - pulling the tail of the left AND right
November 29th, 2012
5:28 pm
Your only concern, sock puppet, is to follow Kyle’s rules and try to tell the truth. If you’re capable, add something of substance.
But I’m site you already knew that being on this blog before.
md
November 29th, 2012
5:28 pm
“and didn’t Perdue change something regarding deductions for interests on your home?”
I rent a dirt floor shack…