Medicaid Expansion Supporters Don’t Have the Moral High Ground

The emotional appeal for Medicaid expansion in Virginia from Kathryn Kadilak on February 5th in Fauquier Now is riddled with untruths and errors.

Ms. Kadilak assumes that a Medicaid card guarantees access to actual care, but assuredly it does not.  You can find documentation here, here, and here – and those are just the latest three stories on the subject!

She asserts that ER use will go down under Medicaid expansion.  Nothing could be further from the truth.  ER use goes UP, not down, when Medicaid is expanded.  See here, here, and here.  There are lots more where those came from.

She perpetuates the myth of the ‘coverage gap’ – supposedly too poor to buy an Obamacare plan but too well-off to be eligible for Medicaid.  The coverage gap is not the problem expansionistas make it out to be.  In Virginia, several types of recipients are eligible for Medicaid even though they are at or above the Federal Poverty Level – Elderly and Disabled (Long-term Care – 219 percent FPL), Pregnant Women and Children (148 percent Medicaid, 200 percent CHIP), and Seriously Mentally Ill (100 percent).  That just leaves Elderly and Disabled above 80 percent FPL, able-bodied Parents above 48 percent FPL (their children are covered), and the expansion population – childless able-bodied adults – who are not eligible without expansion (eligible up to 138 percent FPL in expansion states).

Not only are the ineligible far fewer than expansion supporters represent, many of them receive cost-sharing subsidies and tax credits under Obamacare (100-400 percent FPL), plus treatment at emergency rooms (under EMTALA) and federally-funded community health centers.  No one in this country is entirely without government-sponsored medical care of some kind.  In that sense, there is no ‘coverage gap’.

Finally, Ms. Kadilak claims that Medicaid expansion is a “moral imperative”.  How is it moral to make it harder for current more vulnerable Medicaid recipients to find a doctor?  How is it moral to send the disabled to the back of the line?  How is it moral to give a higher federal match rate to childless able-bodied adults?  How is it moral to give the short end of the stick to education and other budget priorities, just to fund Medicaid expansion?  Medicaid is already out of control. It accounts for some 10 percent of the annual federal budget deficit.

Ms. Kadilak’s moral compass always points to Medicaid expansion regardless of all other considerations. Medicaid expansion is like iron ore.  It makes moral compasses go haywire, to the point where, not only Ms. Kadilak, but Virginia’s current Governor and many other politicians both Republican and Democrat think it is a virtue to give away other people’s money and send the nation deeper into debt.  If that’s your idea of morality, no thanks.

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