Expand Medicaid? Why would NH do that?
January 04. 2014 10:02PM
Medicaid expansion is high on the New Hampshire Democratic Party's wish list for 2014. Don't believe us? In the column on the opposite page, House Speaker Terie Norelli lists it as a top priority. The question is: why?
Much of what the public has been told about Medicaid is wrong. It simply does not do what its most passionate advocates claim.
Last May the New England Journal of Medicine published the results of a huge Medicaid study in Oregon. A team led by MIT economist Amy Finkelstein compared people who were enrolled in Medicaid during Oregon's 2008 expansion with others who did not win the Medicaid enrollment lottery.
"This randomized, controlled study showed that Medicaid coverage generated no significant improvements in measured physical health outcomes in the first 2 years, but it did increase use of health care services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain," the study concluded.
In short, after two years, low-income Oregonians who enrolled in Medicaid were no healthier than their counterparts who did not enroll - but they did spend more on medical care. The Medicaid coverage bought them peace of mind, but not better health.
Last week data from another phase of Finkelstein's study were released. She found that people who enrolled in Medicaid visited the emergency room more often (a rise of 40 percent), not less often, as President Obama and other Obamacare supporters had predicted.
"Now we know - the hope that Medicaid will save money turns out not to be correct, at least in the first two years," she said.
If Medicaid does not make people healthier and does not reduce ER visits, why in the world would New Hampshire enroll tens of thousands more residents in the program? Proponents of expansion say that Washington is giving us "free" money, so we might as well take it and enroll these people at no cost.
That's what Pennsylvania and Delaware thought, too. But then the Department of Health and Human Services changed how it calculated personal income for Medicaid patients. Delaware now has to cover $25 million in Medicaid costs that Washington was paying under the old formula.
In Pennsylvania the figure is expected to be $350 million. So much for the idea that Medicaid is a spigot pouring free money into the state. The formulas can change at any time, either by administrative decision or by law.
Medicaid is a boondoggle. There are far better ways to insure low-income people than by enrolling them in Medicaid. The one and only reason the left so passionately advocates expansion is to sweep more people into government-provided health insurance.
People who are more dependent upon the government are therefore more dependent upon the party of government - the Democrats. This is what Medicaid expansion is all about. New Hampshire must not consign 50,000 Granite Staters to a bad, government-run health insurance program just to boost the electoral prospects of one party.