“One section of the $3.5 trillion bill Democrats are trying to push through Congress would create a new federal Medicaid program to cover mainly childless adults,” he explains.
A Galen senior fellow and president and founder of the new Paragon Health Institute, Blase writes “Democrats are frustrated that 12 states haven’t accepted the Affordable Care Act’s cash enticements to cover able-bodied childless adults in Medicaid.
“The reconciliation bill would give the health and human services secretary the ability to run a federal Medicaid expansion over state objections, starting in 2025. Before then, the feds would send subsidies directly to health insurers to cover this population in Affordable Care Act exchange plans.”
The new program would foist even more costs onto federal taxpayers. “The federal government will ostensibly pay 100% of the costs of the new federal Medicaid program,” but states that already have expanded the program may find that a better deal than the current arrangement that requires them to pay 10% of Medicaid costs.
Aside from creating a major new federal program without a single congressional hearing, “this won’t be good health coverage for the Americans who rely on it,” Blase writes.
“Medicaid expansion increases demand for healthcare but does nothing to increase the number of doctors or nurses who treat patients.
“Low Medicaid payment rates—about half of what private insurers pay for primary-care services—discourage doctors from participating,” he writes. “Perhaps most notably, obstetrician-gynecologists are 20% less likely to accept Medicaid in expansion states than in non-expansion states. This statistic is especially worrisome since Medicaid pays for more than 40% of all U.S. births.” In the piece, Blase provides numerous examples of problems associated with the ACA’s Medicaid expansion.
He concludes: “There are better ways to help people in need. Medicaid should be targeted to help vulnerable patients, such as low-income pregnant women, children and those with disabilities. Other low-income individuals could be allowed to opt out and use the subsidies to buy the care or coverage of their choice.”
Brian Blase is a Galen Institute senior fellow and president and founder of the new Paragon Health Institute.