Medicaid expansion is bad news for all Pennsylvanians. Here are four reasons why:
1. Expansion undermines the quality of health care. Medicaid patients suffer from limited access to care. A pediatric practice in Harrisburg recently cut hundreds of Medicaid patients, forcing one mom to call five different offices before she could find a pediatrician willing to see her autistic children. Statewide, one third of doctors do not accept new Medicaid patients. Adding more patients without increasing the number of doctors accepting Medicaid will create longer wait times and continue to discourage preventative care.
2. Rejecting the expansion will reduce the federal deficit. If Pennsylvania chooses not to expand Medicaid those funds do not go to another state, federal spending simply declines. According to Christina Corieri from the Goldwater Institute;
Using figures compiled by Kaiser and our own research at the state level, the Goldwater Institute estimates that the federal tab for Medicaid expansion has been reduced by more than $424 billion in new federal spending over the next eight years thanks to the 18 states that have already opted out. If the 12 still-undecided states also decide to opt out, there will be an additional $185 billion in savings.
The more than $609 billion in total savings from these 30 states would represent over 50% of the expected federal spending on the Medicaid expansion. A drop in the bucket? That’s more than seven times the $85 billion in 2013 sequester cuts and more than half the projected federal deficit for this fiscal year.
Pennsylvania alone can reduce the deficit by $43 billion.
3. Medicaid spending is already unsustainable. Even without expansion, state Medicaid spending is projected to continue to grow faster than revenues, requiring significant tax increases or reductions in other areas of spending, like education. An expansion would only exacerbate the already bleak fiscal situation. Expansion will cost state taxpayers an additional $2 billion by 2022, on top of current spending.
4. We can’t count on federal politicians to keep their promises. Studies promoting Medicaid expansion include rosy assumptions that are far from certain. President Obama has already proposedlowering the federal matching rate. The Obama administration has also proposed delaying reductions to the reimbursements hospitals receive for charity care (DSH payments), something supporters of expansion claim Medicaid expansion is needed to offset.
Finally, acting Secretary of the Pennsylvania Department of Welfare, Beverley Mackereth, is concerned about the federal government’s review of state provider taxes, which are used to draw down more federal funding. If the federal government changes those rules, Pennsylvania could face an additional $1.5 billion hole after seven years.
For more on the downsides of expansion, read Medicaid Expansion Myths and Facts.