I have been a budget nut lately. I have found Paul Ryan insightful in some areas of his budget. Yet, I cannot seem to compromise on the belief that Republicans have it wrong toward health care. In Arkansas, our legislature is debating about Medicaid expansion. I say do it. The White House has given us a sweet deal. With Medicaid expansion, Arkansas can use federal dollars in a different way. Instead of putting individuals and families on traditional Medicaid rolls, (you know, that plan in which some clinics are no longer taking and in which hospitals often are reimbursed less than their private insurance counterparts) Arkansas can use the funds to purchase private insurance for the uninsured. It is going to be a win-win. Let’s take a look why, but first here is the basic environment:
Who is it for?–According to the Kaiser Family Foundation, medicaid enrollees are largely made up of children. Additionally, roughly 10% of American children are uninsured. Seems immoral.
The typical uninsured American is a young, white working family (2/3 of the uninsured pie). This is largely due to changing fringe benefits, increases in payroll taxes, and increases in private health insurance payments over the past four and half decades. This situation is made worse by the subtle decrease in wages. Blue collar families are willing to forgo health insurance because of these factors. What is even more frustrating is that these blue collar workers are usually unable to enroll in Medicaid because they make enough money to not qualify, but they make too little to purchase a decent family health-plan in the non-group private health insurance sector. In the Affordable Health-Care Act, Medicaid expansion will cover these “fall through the cracks” families.
Additionally, over the the decades, everyone is contributing more to health-insurance– but given the ratio workers have been paying more, despite that the top 1% increased their share of the wealth during the economic crisis. (Although, to be fair, this is largely attributed to controlling their financial lost during the crisis. One control measure, HOWEVER, was in the form of a government bailout. Thanks middle-class!)
Thrust: I cannot support expansion because it is likely to enroll that 22% of the uninsured that is non-working and unemployed.
Parry: 51% of all healthcare expenditures in the U.S. is toward hospitals and physician care. Additionally, federal law states that any hospital that accepts medicare or medicaid must accept all patients regardless of their ability to pay. (45% of U.S. patients pay for their healthcare by using these programs, therefore hospitals cannot afford to not take medicare and medicaid payments) Thus, when a non-working, uninsured patient enters a hospital for treatment, the hospital will eventually compensate for their lost by increasing the cost on everyone else. Thus, you are already paying for it.
All states should do their best to grab this private option expansion. Doctors and hospitals will be reimbursed at a better level, most of these new enrollees will be working blue collar families, and private insurance companies will have greater leverage in negotiating cost with health care providers as opposed to the United States government.
If Arkansas or other states vote against the private option, I can’t help but feel that we have entered into an ideological insane asylum in which those members need to be replaced with utilitarian mindful, pragmatic, and moderate legislatures.