This Is No Obamacare Success Story, Mr. President
by Laura Trueman, Heritage Foundation, December 20, 2013
Most of the people applying for Obamacare are being funneled into Medicaid. President Obama boasted that sending these 803,000 people to Medicaid is an under-reported Obamacare success.
But this does not equal success—in fact, it’s a negative for the enrollees themselves and for taxpayers. Here are four reasons why this is bad news.
1. Harder to Get Care
Being signed up for Medicaid does not mean having access to care. As Heritage’s Kevin Dayaratna concluded in his study, “Academic literature has consistently illustrated that Medicaid patients—adults and children—have inferior access to health care, and notably poorer health outcomes, than privately insured patients.”
This is because Medicaid pays doctors much less than privately insured patients and even those with Medicare, all the while imposing lots of red tape.
In 2011, just 69 percent of doctors nationwide were accepting new Medicaid patients, with acceptance rates in some states as low as 40 percent to 50 percent.
Coverage doesn’t hold much value if you can’t get a doctor to see you, and since Obamacare dramatically increases Medicaid enrollment, the problems are likely to get worse.
2. Poorer Health Outcomes
Just as Medicaid “coverage” isn’t a guarantee of access to care, it isn’t a guarantee of quality care, either.
A study published in The New England Journal of Medicine looked at how Medicaid enrollees fared compared to a similar (but not enrolled) population. Despite the fact that Oregon’s Medicaid program spent an average of $4,400 per enrollee, “Medicaid generated no significant improvements in measured physical health outcomes.”
3. Jeopardizing Coverage
Medicaid, historically, has been targeted to specific, vulnerable Americans: low-income disabled, low-income moms and kids, and low-income seniors. Obamacare changed that.
Now, in the 26 states that have opted to expand Medicaid, more Americans qualify, even if they are able-bodied and can work. Health policy analyst Chris Jacobs notes the dangers of Medicaid expansion beyond those it was intended to serve:
By extending health coverage to those who should be able to work, Obamacare could jeopardize the coverage of disabled Americans. And by subsidizing health coverage for millions of unemployed and underemployed, Obamacare could accelerate the development of a permanent underclass that has little financial incentive to work.
4. It’s Not Free
Even before Obamacare became law, Medicaid was already the third-largest program in the federal government, as well as one of the two fastest-growing. With Obamacare, the Congressional Budget Office projects that federal spending on Medicaid will more than double over the next 10 years.
Medicaid, traditionally, is paid for with both federal and state dollars. Expanding Medicaid will cost states plenty—it is not “free,” writes Heritage scholar Drew Gonshorowski.
For many states, paying for Medicaid will mean one of two things (or some of both): 1) cutting funding for other items like education or transportation, or 2) increasing taxes.
Obamacare isn’t the answer. We need an alternative that gives people quality health coverage.
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