Years before the implementation of the Affordable Care Act (Obamacare), the state of Utah established a small-business health exchange that allowed small employers and their employees to shop for private health insurance. I was a co-sponsor of this legislation, with the ultimate goal of covering all Utahns.
Along with the haphazard implementation of the ACA, the Obama administration has assumed that states will expand Medicaid and put themselves in a position that when federal dollars stop flowing, the states will feel compelled to prop up a program that most can ill afford. As it is, Medicaid is eating up more and more of our state budget every year, with no end in sight. As this occurs, it cuts into benefits in other areas such as education and transportation.
Expanding the Medicaid program under Obamacare would make us more dependent on a fiscally irresponsible federal government. Many of us are concerned that 40 percent of the money the state of Utah spends comes from a federal government that borrows 40 percent of its money. This is obviously an unsustainable model, and sets us up for unnecessarily difficult choices when the federal government does pull back; not if, but when.
In addition to the fiscal problems with an expansion, Medicaid isn’t ideal and should be used only when absolutely necessary. Unfortunately, we are starting to see problems in states that have expanded their Medicaid programs where people who were previously covered under low-cost private insurance have been forced onto Medicaid through the exchanges.
A recent study found that, after adjusting for age, gender, income, geographic region, operation and comorbid conditions, Medicaid patients had nearly twice the chance of dying as those with private insurance, even though their hospital stays were substantially longer and cost over 26 percent more.
I had a doctor recently tell me just that he can’t accept Medicaid patients. The reimbursement rates are so low that he loses money on every single Medicaid patient he sees, and can’t put himself in the position of not being able to pay his overhead and staff.