Enough About Medicaid. What About the Rest of Us?

There is more to life than Medicaid.

D.C. conservatives say it’s the best Medicaid reform bill ever. Democrats and progressive Republicans say it’s a crippling cut to the poor and immoral. What nobody is talking about is the rest of the health care and health insurance market and how it is immoral to ensure than no middle-income family can live with dignity without unsustainable taxpayer support. Whatever we do or don’t do with Medicaid, why do we need to destroy the rest of the market for the debate over Medicaid? Why is nobody talking about healing the private market first?

Obamacare’s actuarily insolvent regulations and market-distorting exchanges and subsidies, built on top of existing government-sponsored distortions, destroyed health insurance in America and made health care unaffordable for all but the wealthy. That is a fact. That premiums have tripled in only the fourth year of implementation and that they will skyrocket thanks to only one or two insurers having a monopoly in most of the country is a reality before our eyes, not just a projection score from CBO. Why is nobody discussing ways to solve the private market crisis — repeal of Obamacare and enactment of free-market, supply-side health care reforms?

The supposed rationale for this arson of our health care system was the pursuit of universal coverage. But the reality is that 84 percent of all coverage increases came from Medicaid, not from the private insurance market. Even much of the remaining 16 percent increase since 2011 came from 1) Young individuals who never wanted insurance but were coerced into it by the individual mandate; 2) More people getting employer plans thanks to the recovering job market. Unemployment decreased from 10 percent to 4.3 percent; and 3) Individuals who are getting lavish subsidies but only need the subsidies because the Obamacare regulations made insurance unaffordable without them. Private insurance coverage for everyone older than 26 has actually decreased since enactment of Obamacare.

The remaining middle-income Americans and small business owners, thus, must suffer from crushing costs the size of another mortgage … for what?

Why did we have to destroy the entire market just to expand Medicaid?

A true compromise that will expose the duplicity of progressive Republicans and Democrats

To that end, here is my proposal to solve the problem and assuage the concerns of progressive Republicans while disarming the talking point of the left.

You want Medicaid expansion? Here, go have it. We won’t touch it at all. Go enjoy it. It’s all funny money anyway, and we have long since crossed the point of no return with the debt. As late as 1987, we spent just $27 billion on Medicaid; as late as 2008, we spent $200 billion on it; and now we spend close to $400 billion. The debate between the two sides is over whether we will spend $500 billion or $620 billion on Medicaid by 2026, both lowball estimates unless we actually solve the core problem and open up a free market in health care and health insurance. Plus, either way, the proposed “cuts” to Medicaid under the GOP plan will never occur, cannot occur given the dynamics of the rest of the bill, and are merely a talking point to get conservatives on board with maintaining the core of Obamacare.
Perforce, if this is the big reason why RINOs are having tantrums, let’s cede this issue, which will be ceded anyway, and demand repeal of the more critical elements of Obamacare in return.

In addition, let’s throw $200-$300 billion over 10 years at a federal high-risk pool that is structured like the “Maine model” to ensure insurers can’t bid up the price and make it an open-ended entitlement, but will deal with the remaining chronically ill who are not covered by other programs. This is more than enough to deal with the remaining people who aren’t on Medicare, Medicaid+expansion, SCHIP, VA, TRICARE, state programs, and existing state and federal programs for pre-existing conditions. Yes, we already spend $1.6 trillion on health care. Now, enough is enough.

Again, this is not my ideal plan, but we are going to spend this money anyway under every plan anyway. (For more from the author of “Enough About Medicaid. What About the Rest of Us?” please click HERE)

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