McAuliffe Muffs Medicaid Expansion Questions

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Photo courtesy of Watchdog.

Photo courtesy of Watchdog

Originally posted at Liberato.US

The Virginia Medicaid Reform Team (VMRT – a group of grassroots activists) recently sent Virginia Governor Terry McAuliffe the first of several sets of hard questions about Medicaid expansion.

There was no response from the Governor.

As VMRT wrote his office:

Governor McAuliffe recently proposed Medicaid expansion for the third time. However, Virginians for Quality Healthcare asked a number of hard questions about Medicaid expansion (set forth below) when the Governor first proposed it two years ago.

VQH’s questions address such points as the exploding costs of expansion in other states, the inadvisability of turning a poverty program into a middle-class entitlement, and the fact that Medicaid provides worse health outcomes than insurance.

These questions have never been answered by the Governor or other expansion supporters, but they should be. Any serious discussion of the issue would include the downsides, not just pump the glorious benefits of spending ‘free’ money like there was no tomorrow.

In one week, VMRT will publish the results of this inquiry so that all Virginia residents can weigh for themselves the sufficiency of the Governor’s answers or, if he chooses not to answer, his nonresponse.

VMRT looks forward to the Governor’s expeditious replies.

Hard Questions Expansion Supporters Can’t Answer

  1. 1. Why is it a good idea to change Medicaid from a poverty program into a middle class entitlement?
  2.  Why does it make sense to start these reforms and seek waivers without having seen the results of the experiments before we talk about expanding Medicaid?
  3. Why do you think the state can reverse course and get out of expansion if things go wrong? Two think tanks say it’s not possible and there is no opt-out provided in the Obamacare statute or in the Supreme Court’s ruling last summer. Virginia lawmakers tried to write the possibility of reversal into state law, but why do you think the federal government would let Virginia off the hook? Memos and letters from HHS purporting to allow for reversal don’t have the force of law, do they? Why should we accept those non-binding assurances when we know how imperiously Washington is acting these days?
  4. Medicaid provides the worst healthcare outcomes when compared to every other form of insurance in America. Why is it a good idea to dump 400,000 more Virginia citizens onto Medicaid and condemn them to poor health outcomes? Is that what you would want for you and your family? If it’s not good enough for you, why is it good enough for anybody else?
  5. Isn’t it true that hospitals lose money on every Medicaid patient that comes in the door? Why, then, do hospitals think it makes sense expand the program? Do they really expect to “make it up on volume”? If you believe that, I have a bridge in Brooklyn to sell you.
  6. If the hospitals are losing money on indigent care, how does dumping the middle class onto Medicaid solve the hospital’s funding problem?
  7. With so many doctors leaving practice because of Obamacare, and others rejecting Medicaid patients, what makes you think these additional 400,000 patients will even be able to see a doctor?
  8. Isn’t it true that at least two voting members of the commission have businesses that feed off of Medicaid and stand to personally benefit from expansion? Why should we nod our heads and say this is good public policy when the private, financial conflicts of interest driving the move toward expansion are glaringly apparent for all to see? Why should we put up with such cronyism? Don’t we have a right to expect more from our elected representatives? They work for us, not the other way around.
  9. If Virginia’s Medicaid program needs reform, why don’t we get a complete waiver from the federal government like Rhode Island did and start from scratch with the state in complete control? Moreover, why aren’t block grants a better way to go?

Medicaid expansion has already caused costs to explode in Hawaii, California, Connecticut, Arizona, and Maine. Who do we go see if the rosy cost projections and glowing predictions about reforms don’t work out as advertised? Who do we hold accountable when the temporary politicians who want to give us this “Gift of a Baby Elephant” will be long gone from office?