Landrieu addresses in writing the Legislature’s decision not to expand
coverage to all but the lowest-income households already covered, a choice made
optional for states as a result of the U.S. Supreme Court ruling almost a year
ago on the matter. She berates its majority and Gov. Bobby
Jindal for this opposition, and gives alleged justifications that, when
analyzed in the light of truth, simply do not hold up.
Initially, she claims that “By saying no to the expansion, they said no to positive
economic impacts to Louisiana’s economy and health care improvements for many
people who desperately need and deserve better care.” She then cites statistics
from the leftist advocacy group Families USA that purport to show increased
economic impact and jobs – but naturally ignores
the report’s lack of comprehensiveness in its approach that makes its
conclusions next to worthless.
She also never mentions that from a holistic perspective, that expansion for states will have an overall
negative economic impact, because of the additional money it removes from
the economy transferred to pay for an inefficient program, which can come in
the form of higher taxes, and the displacement of clients it will cause to
private insurers. Already, data collected by the Federal Reserve shows at the
national level Obamacare as a whole, even at this early stage, is having a significant negative economic impact.
The same should be expected for its derivative Medicaid expansion.
Proponents like Landrieu will argue that perhaps other states might see
a negative impact economically, but because Louisiana has a higher proportion
of uninsured poor it could benefit from the increased federal money pumped into
the system. But this is contradicted by the fact that the more uninsured that
enroll (and also the more insured displaced), the higher a state’s cost becomes,
necessitating either or both of draining more from other state government programs
or raising taxes.
Landrieu employs the typical dodge here, in arguing “the governor’s own
estimate from the Department of Health and Hospitals shows savings as high as
$367 million over 10 years.” Stating it this way shows she either didn’t
read the report or wishes to mislead deliberately. In fact, the only “savings”
that occur disappear as soon as the federal reimbursement rate drops to 90
percent in 2020; after that, the state progressively loses more money every
year. By 2023, the loss is $93 million a year, over 15 percent higher than the
previous. At that rate, over the next decade (2024-33) the state will pay a
staggering $2.675 billion more because of expansion – and it’s unlikely that
the federal government will keep its match that high with pressure to blend it
with the regular (FMAP) rate that will be at least 20 percentage points lower.
There is no way that will not have a negative economic impact on Louisiana.
She also misleads with her claim that expansion (with Obamacare) would “to deliver high-quality
and affordable health care to the middle class and working poor.” Certainly as
far as the Medicaid component that would deliver to the poor does, that is
entirely false. The most recent research on the quality of Medicaid provision,
relative to receiving no care at all, demonstrates
there’s really no difference, and also backs past studies showing a
significant gap in care quality of Medicaid to private insurers – which expansion
under current rules would not facilitate, even
under modified models.
Finally, Landrieu also employs
the “use-it-or-lose” fiction: “Even more distressing is the fact that Louisianans’
federal tax dollars will be used to pay for better health care for people in
other states.” Besides the obvious error that it produces “better health care,”
this passage is entirely
false: the money that comes into the program is formulaic on the basis of
usage and is not a pot paid into regardless of usage. But even if it were true,
why throw good money after bad given the demonstrated negative economic impact,
drain to the state’s treasury, and inferior outcomes?
Understand that Landrieu wrote
this to try to address perhaps her most vulnerable issue, to bolster her bad
decision that foisted Obamacare on America, a vote that no doubt during the
campaign will be hammered home by her main opponent Rep. Bill Cassidy who has enormous
credibility on this issue. He remains a medical doctor in practice who sees
Medicaid patients in that capacity on a regular basis; outside of photo
opportunities, likely the only people Landrieu interacts with who use Medicaid
are her domestics (citizens or otherwise). By trying to paint expansion as a
good deal, she also tries to justify that vote.
And in doing so here, she unintentionally
serves up great irony. Refusing to acknowledge all of the bad effects of
expansion, the only reason then she can conjure to explain why state
policy-makers, Jindal in particular, refused was because “political agendas and
future campaign prospects got in the way.” Yet her piece through its amazing
avoidance of reality is nothing more than a craven surrender to her own
political agenda and future campaign prospects. As is typical, she accuses her
opponents of being the very thing she is.
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