Medicaid is a failed program that shouldn’t be expanded without reform. That was the message of yesterday’s House Health Committee hearing on Medicaid expansion. In contrast to House Human Services hearing encouraging expansion, the testifiers emphasized the programs poor performance and high cost.
Dr. Lynn Jensen emphasized insurance does not equal access to health care. And Congressman Joe Pitts warned, “There is no way the federal government can keep these promises. We can’t afford the entitlement promises we made before the ACA, and we can’t afford this either. . . We broke our promise on special education funding. . . More recently we broke our promise to pay for your program for people with pre-existing conditions.”
Despite these dire predictions, Senate Republicans announced last night that they will consider expanding Medicaid with added opt-out protections. But the only adequate condition for accepting Medicaid expansion is full state flexibility to reform Medicaid. Lawmakers should reject anything less.
- Expansion won’t help the needy. Medicaid expansion will crowd out private insurance coverage. More than half of all newly eligible recipients currently have private insurance. Plus, as demonstrated here and here, Medicaid provides poor quality care to beneficiaries. Primary care is so poor that compared to the privately insured, more Medicaid patients end up in the ER.
- The money isn’t free or reliable. All federal funds come from taxes that will be imposed on Pennsylvania families and job creators. President Obama has already twice proposed reducing the reimbursement rate to states for the Medicaid expansion costs.
- Expansion will further strain state finances. While there is dispute over short term savings to the state budget, in the long run, expansion will assuredly cost the state. Those costs are in addition to the significant strain Medicaid is already imposing on state and federal finances.
So if expansion isn’t the solution, what can we do about the uninsured? We can reform Medicaid to ensure it serves those who truly need care, not those who already have insurance, and that it provides quality care so safety net services like community clinics and hospital ER rooms are not inundated with Medicaid patients.
Governor Corbett understands we can’t just throw more people into a broken system, that’s why he is in talks with the federal government to reform Medicaid.