Note: This article originally appeared in the Austin American-Statesman on August 6, 2012.
Something funny happened in the Mexico elections on July 1. Voters bribed with gift cards to cast ballots for the winning candidate, Enrique Peña Nieto, arrived at stores to find their bounty was far less than promised. They sold their independence for easy money, and were left with neither.
A more apt metaphor for the promise of Medicaid expansion under ObamaCare would be hard to find.
After the Supreme Court’s ruling on the White House health-care scheme, state compliance with its Medicaid expansion became optional. On the surface, it seems like a good deal: the law pays for 100 percent of the expansion for the first two years, declining to 90 percent after that.
But scratch that surface, and Medicaid expansion under ObamaCare is just a setup to have the rug pulled out from under us – for Texas families and state government alike.
An expanded Medicaid program means less health-care choice, and worse health-care outcomes, for the Texans and Texas families in it. The program will restrict access to nearly two-thirds of the state’s physicians. Worse, studies have shown that health-care outcomes under Medicaid are actually worse than those with no insurance coverage at all. Finally, the all-or-nothing structure of Medicaid makes it exceedingly difficult for Texans to get off the program and regain their independence.
All Texans are rightly concerned about health-care access and quality. The sad reality is that ObamaCare’s Medicaid expansion will diminish both.
Fiscally, this expansion is riddled with hidden costs and budgetary pitfalls. There are significant implementation costs associated with updating a Medicaid program to handle an entirely new eligibility group. Furthermore, the state’s Medicaid costs are already rising faster than state revenues. If Texas cannot afford the program today, why do we think we can afford the 10 percent five years from now? The Federal government’s own financial capacity to provide the promised 90 percent is also highly suspect.
Once state and federal governments realize they can’t afford the expanded Medicaid, it will be too late – and it will be Texas families and households who pick up the tab.
Fortunately, Gov. Rick Perry took the right step when he announced that Texas will not participate in the ObamaCare Medicaid-expansion boondoggle. But Texas still needs positive solutions in this sphere.
If Washington, D.C., truly cares about improving health outcomes and patient choice, they should block-grant Medicaid. Texas can design a program that does everything the ObamaCare Medicaid expansion won’t: empower Texans, give them access to physicians, generate good outcomes, and preserve independence. The federal government should also eliminate tax discrimination against individual insurance. This would allow for the growth of a healthy, robust individual insurance market that would help put Texans, rather than their employers, in the healthcare driver’s seat.
Innovation like this, born of policymaking autonomy for the state, is the real solution to the problems that Medicaid expansion is meant to solve. Without it, Texans – and all Americans – will find themselves, like a Mexican voter, poorer for having believed the false promises of government money.
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