Posted by: Allison Rice | March 27, 2013

Even USA Today endorses Medicaid expansion

An editorial in USA Today bemoans the intransigence of most Republican governors on Medicaid expansion.  This is the newspaper that awaits American business travelers outside their hotel room each morning. When Medicaid expansion is endorsed by America’s wonder-bread newspaper, that’s really saying something. Sure looks pretty mainstream.

Titled, Medicaid expansion fight harms you: Our view, the piece makes the familiar arguments for Medicaid expansion, and points out that the governors who are the most outspoken opponents come from states with among the highest numbers of uninsured residents.

Thanks to last June’s Supreme Court ruling that made the expansion optional for states, a group of Republican governors and legislators has opened a new front in their ideological war against ObamaCare — at the expense of their poorest residents, their state’s hospitals and their own state budgets.

This is remarkably crass politics, especially when you consider that some of the governors leading the charge — Rick Perry of Texas, Bobby Jindal of Louisiana and Nikki Haley of South Carolina – preside over states with some of the nation’s highest percentages of uninsured residents.

Texas is No. 1 (27% uninsured), and Louisiana and South Carolina are tied for No. 5 (23% uninsured). Handed a golden opportunity to fix this, Perry, Jindal, Haley and more than a dozen other governors are saying no, blocking an estimated 5 million people from obtaining coverage.

The piece also takes issue with an idea that is gaining traction among those who put their faith in the private market: cover the uninsured by paying for private insurance, rather than Medicaid. The USA Today editorial board correctly notes that this is a much more expensive way to pay for coverage, given the much higher administrative costs (including profit and marketing) for private insurance, as compared to government-run Medicaid:

Other governors want to let private insurance participate in the Medicare expansion, and the Obama administration hasn’t ruled this out. But it’s hard to see how adding a middleman would be more efficient. The Congressional Budget Office says Medicaid can cover a patient for $6,000 a year in 2022, while the cost of private insurance would be $9,000, or fully 50% more.

No doubt we’ll see more on this topic. I’ll be interested to see how private insurance can be a cost effective solution.


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