Medicaid Expansion Not Working Out as States Had “Predicted”

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Encouraging Virginians not to expand Medicaid to able-bodied, childless adults, Brooklyn Roberts looks at some results from states that have moved forward with the change:

As an example, let’s look at Oregon, a state that began expanding Medicaid in 2008. Officials there lacked funding for the total number of applicants, so they conducted a random lottery and selected enrollees from a waiting list, thus making Oregon an ideal state for study. What they found was that gaining Medicaid coverage increased health care usage and costs across a wide range of settings, and emergency room visits increased by 40 percent in the newly covered group. Proponents of the expansion argued the initial spike in ER visits was due to pent-up needs and would decrease as time went on.

That has not been the case. Oregon’s growth in Medicaid spending between 2012 and 2016 was 83.1 percent. A follow-up study in the New England Journal of Medicine concluded the value of expansion for recipients was quite low — 20 to 40 cents per dollar of government spending.

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So, the expansion increases health-care usage in ways that weren’t predicted by the officials who’ve implemented the expansion, and those officials have proven even more egregiously incorrect when it comes to predicting how many people would sign up.  (We could argue about whether that was a flaw in their methodology or something more like deception; after all, they’ve ushered a lot of people into Medicaid by rerouting them through health benefits exchanges that were supposed to sell plans for actual money.)

In Rhode Island, our government officials signed up for the expansion almost before it was officially offered.  We should force them to reconsider how they do things.



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