This week, the House is preparing to vote on the Senate-passed health care bill, which depends on a massive expansion of Medicaid to reduce the number of uninsured.
However, as has become apparent in the months of debate surrounding Democrats’ health care proposals, all that glitters is not gold—especially in the case of expanding Medicaid, a low-quality, poorly-functioning federal-state program which fails to meet the needs of its beneficiaries. Increasing the number of citizens dependent on this program fails to address its numerous shortcomings, and instead applies them to millions more.
A recent article in the New York Times portrays the plights of current Medicaid beneficiaries which are slowly becoming the norm. Since Medicaid reimburses doctors significantly below the cost of providing care, more and more doctors are being forced to turn patients away. According to Dr. Saed J. Sahouri, “…we’re really losing money on seeing those patients, not even breaking even. We were starting to lose more and more money, month after month.”
As it becomes harder for Medicaid beneficiaries to find providers, more and more rely on emergency room care—in fact, Medicaid enrollees are more likely than even the uninsured to end up in emergency rooms in lieu of primary care.
As former Heritage analyst Dennis Smith points out, Medicaid spending is demanding a larger portion of state budgets, squeezing out other state priorities from education to transportation. This is a trend which is expected to continue in the years ahead.
If the federal government is serious about health care reform, expanding Medicaid is the worst way to go. Making more Americans dependent on this program may decrease the number of uninsured, but will do nothing to improve the access and quality issues plaguing the program. Moreover, federal funding to cover the expansion only offers states temporary relief and simply shifts these costs to federal taxpayers. Eventually states (and state taxpayers) will be left to pick up the cost, only intensifying the problems in the future.
Washington can do better by reforming Medicaid so that it works for those who currently use it. Heritage analyst Nina Owcharenko outlines what states legislators and Congress can do to improve the quality of Medicaid:
States … should mainstream some Medicaid enrollees into private coverage and adopt consumer-directed models to promote personal responsibility and enable individuals to take control of their health care decisions… federal policymakers should look for ways to make this process easier and remove obstacles to change.
…Congress should enact key health care initiatives, such as health care tax credits, and private long-term care incentives that complement Medicaid reform and relieve the increasing pressures on state Medicaid budgets.
Millions of Americans currently struggle to receive adequate care due to Medicaid’s inadequacies. Adding more families to these poor performing programs will make these problems worse.