Medicaid And Medicaid Expansion: The Dirty "Big" Secrets The Democrats Don't Want You To Know

Last week, when ObamaCare was  "generally" upheld by the Supreme Court, a key provision of that law, the forced expansion of Medicaid, was actually struck down.  In a 7-to-2, majority decision, the Supreme Court ruled that the federal government has no right to tell the states that they must expand Medicaid and and eat the cost or lose all federal funding for their existing Medicare programs.  Since then, at least 8 Governors  -- all Republicans --  have declared that they won't participate in the expansion; citing budget deficits being behind their decisions.

Surprisingly, the Democrats and the main stream media have been somewhat cold in saying or reporting anything about this.  The only time the press actually mentions it, at all, is to paint some Republican Governor in a negative light by noting that thousands of low-income citizens will be without access to health care.  But, that's an intentionally political deception.  For starters, only about 42% of low-income wage earners are without any health insurance.  The majority either get employer-provided insurance; or buy it directly, themselves; or, get their care through the Veterans Administration or through the Medicare disability program.  Secondly, since 1986, anyone in America, not insured, could go to an emergency room and expect to get care without question or any real commitment to pay.  Which is what those uninsured low-income people have been doing for years.


Just so you know. Medicaid is a program that was designed to give health care access to the very poorest of our country.  Basically, those people and families whose incomes fall below the currently defined threshold for poverty are all eligible for this program.  The cost of the program is shared by both the federal government and by the states; with the federal government currently covering 57% of the expense. In 2010,  Medicaid had 53 million participants and the overall cost was $409 billion.

Now to the dirty "big" secrets.  

Secret 1: Medicaid is an extremely expensive program.

As I indicated, above, the 2010 overall cost of Medicaid was $409 billion.  When you divide that number by the number of program participants, you get a per person cost of $7717.  But, you see, that per capita cost is $2677 higher than what the Kaiser Family Foundation said it would cost to buy private, individual health insurance in 2010; proving that, once again, the government never does anything cheaper than the private sector.  That's something to keep in mind when liberals tout the savings and benefits of ObamaCare.  And, that high cost is the reason that many states have adopted a program called HIPP (Health Insurance Premium Payment) whereby Medicaid participants are given a check and allowed to buy their own insurance; saving  millions in the process. The concept of HIPP is one of the programs by which Republicans are eying to reduce the massive cost of both Medicaid and Medicare.

Secret 2: 41% of the population already receives government sponsored health care.

Of the government sponsored health care programs, Medicaid is the largest with more than 60 million participants.  But if you add an estimated 50 million Medicare participants, and 8 million children in CHIP (Child Health Insurance Program), along with 8.7 million people who are getting federal disability insurance, and another million Vets receiving health care from the Veterans Administration, you get a total of nearly 128 million Americans who are getting their health care from the U.S. government. That's 41 percent of the population. 

Secret 3: The Expansion of Medicaid under ObamaCare was a deceptive move to greatly expand government sponsored health care in America.

For decades, Democrats have dreamed of having a government-run, single-payer health care system in this country; feeling that the current private insurance system disproportionately provides health care to the more affluent of our society.  So, when they started crafting ObamaCare, they seized on the opportunity of progressing that "dream" by expanding Medicaid to the supposed 25 million-low income people who, in theory, make up the majority of the uninsured. The rest of the uninsured would be addressed through the Individual Mandate or through the new health care insurance exchanges.  But the dirty secret here is that there are really about 90 million people in America who are classified as low-income wage earners; of which, about 75 million who could, in theory, be eligible for Medicaid under  ObamaCare. The Democrats are only counting the 25 million of that 75 million because they would have you believe that the remaining 50 million, who already get their health insurance in some other way, would continue to do so.  This is another deception.  Why would anyone continue to pay for my health insurance if  they knew they could get Medicaid insurance for free?  Simply speaking, the Democrats put the Medicaid expansion into ObamaCare so the 75 million more Americans would source their health care from the government; bringing the total being served by the government to 52%.  And, that 52% is a majority base that Democrats could use to win elections.

Secret 4: The cost of the new Medicaid expansion was intentionally hidden by forcing the states to pick up the cost.

By any measure, the expansion of Medicaid to 25 million low-income families and individuals would have a cost in excess of $200 billion the first year; and, then, grow at an estimated rate of 7.3% per year, compounded, thereafter.  That was a hefty chunk of change that would have driven federal deficits up by at least $2.5 trillion in 10 years.   So to avoid this cost and deceptively show that ObamaCare would be deficit neutral, the Democrats offloaded the cost to the states.  And, to make sure the states paid for the program, they inserted language into the ObamaCare law that said that they would lose all federal funding for Medicaid if they didn't fund the expansion.   Of course, as mentioned in the first paragraph, the Supreme Court found this to be thuggery and coercion and struck it down.  But, the fact remains:  If your state does pick up the cost of the expansion, it will show up in you pocketbook in the form of some new tax; for rich and poor, alike.

Secret 5: Medicaid patients will suffer from substandard health care in the future.

Medicaid, like its sister program, Medicare, attempts to control costs by squeezing doctors, hospitals, and other health care providers on the payments that they receive from the government.  As a result, an increasing number of health care providers are either dropping or refusing to take Medicaid (and Medicare) patients.  Like cattle, Medicaid patients are being herded into high volume, low quality, clinics for their medical care; waiting long hours or even days to see a physician or specialist.  So, increasingly, the more affluent of our society are being treated by the good doctors and getting good care.  Something that the Democrats wanted to fix by taking over the health care system. Just like Canada and England, nationalized health care necessarily induces long delays and lower quality into the system. Like the old saying says: "Medical care delayed can be the same as medical care denied.  Especially, when the patient died!"