By almost every measure, modern healthcare laws and policies in the United States—specifically Obamacare with its many falsehoods and dictatorial regulations—have pushed the iconic “granny in her wheelchair” dangerously close to the precipitous cliff. Individually and collectively, Americans are being increasingly squeezed by the healthcare deceit known as the “Affordable Care Act” (ACA) that was imposed on the nation in 2010 by a purely partisan act of Congress. Evidence of this treacherous reality is abundant and compelling, yet liberal politicians and a supportive media continue to ignore the facts and prefer instead to mislead voters by professing one untruth after another.
Since the healthcare law was implemented, promise after promise has been broken. Obamacare cost projections were wildly underestimated; enrollment projections were vastly overestimated; competition in the healthcare marketplaces has shriveled, with most major insurers pulling out after suffering staggering losses; millions of Americans have lost their plans when those insurance companies pulled out; most healthcare co-ops have failed, and the few remaining are in trouble; flaws in the law have led to at least 70 changes to ACA requirements, in response to pressure from special interests, or public protest; the middle class has been attacked by double digit insurance premium hikes and unaffordable deductibles; people are forced to buy coverage for services they don’t need (i.e. to pay for someone else’s medical bills); a new definition of full-time work has forced employers to reduce employees’ hours and push those workers into part-time status. If you liked your doctor, you really couldn’t keep your doctor. Worst of all, Medicaid expansion under Obamacare has been exceedingly costly to states and the federal government, and has dumped a significant segment of the middle class on to the welfare rolls, by extending eligibility to people with incomes 38% greater than the federal poverty level.
Between Summer 2013 and January 2016, there was a net increase of nearly 15.5 million people enrolled in Medicaid … among 49 states reporting data for both periods. Overall, 82% of the net enrollment growth occurred in expansion states.
The colossal impact of these collective results on the nation is well-documented. In a few months, voters will determine whether the United States will pull back from the calamitous cliff, or accelerate momentum irreversibly toward a single-payer system with its socialist underpinnings and income redistribution features, initiated by Obamacare.
Virginia voters and lawmakers in particular should be horrified by new data presented by the U.S. Department of Health and Human Services in its “2015 Actuarial Report for Medicaid.” That report revealed the cost of Medicaid expansion in the U.S. in 2015 was $6,366 per enrollee, which is 49% higher than projections made just one year before. See Charles Blahous’ analysis of the 2015 report for plain-language answers to the question “How can a projection be this far off after only one year?”
One must surely also question the competence and integrity of government estimators, whose work in this case does not inspire confidence or trust among taxpayers. Given what is known after six years of Obamacare, and seeing the experiences of Medicaid expansion states, why would any responsible politician or government official choose that health insurance path for its citizens, a path which attacks the middle class by forcing them into welfare programs, and which also further fuels the out-of-control national debt?
Yet, Medicaid expansion remains a foremost goal of Governor Terry McAuliffe, even though Virginia must confront the reality of a $1.5 billion revenue shortfall. That shortfall will reportedly prevent the state’s public employees from receiving a long-awaited pay raise—one more all-too-familiar broken promise Americans have endured under the social and economic policies of big-government politicians. While government handouts may be politically expedient, such “knee-jerk” solutions are harmful in many dimensions over the long haul: they enlarge the welfare state, shrink employment, and stagnate economic growth while attacking individual dignity and independence.Instead of the relentless onslaught of untruths and socially bankrupt policies like Medicaid expansion, increased public attention should be focused on real, fiscally prudent, and innovative healthcare reform ideas offered by conservative policy analysts and subject-matter experts. See, for example, recent VQH Commentaries “Principles Guiding Health Care Reform” and “Health Care and Independence Day.” Other reform ideas are contained in bills before Virginia’s General Assembly, such as HB193 which calls for repeal of Certificate of Public Need (COPN) laws.
Virginia COPN empowers the State Health Commissioner to determine whether a public need exists for investment in certain medical care facility projects. COPN has permitted the state’s hospital industry to stifle competition; not surprisingly, the Virginia Hospital and Healthcare Association vigorously lobbied Richmond in the 2016 session to preserve COPN, but the issue will be taken up again in 2017.
Notably, among the 14 states that have repealed COPN laws, Pennsylvania and Arizona have proven the benefits of removing monopolistic control. In fact, the Hospital Association of Pennsylvania testified last year:
… (Pennsylvania) hospitals believe that fair competition is essential in health care delivery, just as it is in health care coverage. Competition that enables choice by consumers in accessing health care fosters innovation and improvement in health care and is essential in advancing medial practice and technology.
Advocating COPN repeal in Virginia, Michael Thompson of The Thomas Jefferson Institute for Public Policy states:
Reforming Virginia’s COPN laws should increase access to care, do a better job of controlling health care costs, and encourage more innovative health care solutions.
Even though Virginia’s per capita Medicaid costs are lower than in most states, expanding Medicaid would further constrict the state’s budget. The official fact sheet “2016 Virginia Medicaid at a Glance” states:
While enrollment has increased, spending growth has changed at a rate similar to other states. Although increases in enrollment have been the primary driver of spending increases, other factors affecting expenditures for Medicaid in Virginia include: economic changes such as health care cost inflation, advances in health care technology, and program changes directed by federal and state law.
As voters prepare to elect new leadership in Washington, they should carefully choose whether to continue past policies of government-run healthcare, policies that have been injurious, deceitful, corrupt, and unaffordable, or to elect leaders who want to restore individual freedom of choice and free enterprise-based healthcare in a prosperous America.
Note: This article from Virginians for Quality Healthcare is the tenth in a monthly series on Obamacare, leading up to Election Day, November 8, 2016.
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 Eligibility criteria are somewhat more complex but generally the income threshold for Medicaid expansion qualification is 138% of the federal poverty level. For more information see “Medicaid and CHIP Eligibility levels” Centers for Medicare and Medicaid Services, April 2016.
6 Michael Martz, “Gov. Terry McAuliffe to announce $1.5 billion budget shortfall” Richmond-Times Dispatch, Aug. 24, 2016. http://m.richmond.com/ news/virginia/government- politics/article_106e1403- 781b-5910-af9d-cfadc5c06e26. html?mode=jqm