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Growing Medicaid: The dependency trap


On Sunday, we wrote that the goal of expanding Medicaid is to sweep more Americans into government-provided health insurance. That very day, a prominent liberal writer made the same point.

Medicaid is a poorly designed program that does not even achieve its stated goals. A multi-year study of Oregon’s Medicaid expansion, conducted by MIT economist Amy Finkelstein, found that Medicaid did not improve health outcomes or reduce health care costs. It even increased visits to hospital emergency rooms. But the left is in a great rush to expand it to cover people earning up to 138 percent of the federal poverty level. The New Republic’s Noam Scheiber explained why on Sunday.

“Under Obamacare, uninsured people who earn up to 138 percent of the poverty level (just under $16,000 for a single person in 2013), can qualify for Medicaid, at least in states that opt into the law. This has a few key political consequences, as (University of Chicago professor Harold) Pollack notes. First, it transforms the political constituency for the program. Historically, Medicaid has served extremely poor, frequently minority, patients who either don’t vote or support Democrats when they do. That meant the GOP had no hang-ups about squeezing it. But there will likely be millions of white working-class voters on Medicaid in the coming years. (Even in some conservative states, like Arkansas, Kentucky, and West Virginia.) Once that happens, something tells me Republicans will become more charitably-disposed to the program.

Scheiber goes on to predict that people in the Obamacare exchanges will see the more comprehensive coverage offered by Medicaid and want into the program. The whole point of expansion is to move working-class and eventually middle-class Americans into government dependency. Period. New Hampshire must not fall into that trap.

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