Friday, August 14, 2015
Wednesday, August 12, 2015
The refusal of some 20 Republican governors or state legislatures to accept the ACA Medicaid expansion has to rank as one of the biggest political and moral scandals of modern times. To allow millions of citizens to suffer or die needlessly without health insurance merely to continue a political grudge is beyond reprehensible, but to do so when such state costs are covered between 90% to 100% by the federal government descends to abject immorality. That funding fact, alone, makes today's sad episode one for the history books. Like the "Jim Crow" South orpost-WWII "red-lining" of minority communities, this Republican policy of denying available health insurance to the poor is indefensible on a historic level.
Republicans are aware of their crime and, in particular, know that the biggest PR key to denying their culpability is to pretend that this withheld insurance is not fully or near fully funded by the federal government. After all, what moral person could gratuitously, miserly, refuse health insurance to their own citizens? No, it must be fiscally impossible. Out of the sinners' control. But how?
Enter Fox's Megyn Kelly at the last Republican debate, with as an intentionally dishonest a question that you could imagine:
KELLY: Governor Kasich, You chose to expand Medicaid in your state, unlike several other governors on this stage tonight, and it is already over budget by some estimates costing taxpayers an additional $1.4 billion in just the first 18 months.Wow! I thought: Ohio's Medicaid expansion - passed over objections of the Republican legislature - is already $1.4 billion over budget?!? Holy cow! These Republicans are innocent of heart - or at least forgivably broke. Right?
You defended your Medicaid expansion by invoking God, saying to skeptics that when they arrive in heaven, Saint Peter isn’t going to ask them how small they’ve kept government, but what they have done for the poor.Why should Republican voters, who generally want to shrink government, believe that you won’t use your Saint Peter rationale to expand every government program?
No. This dishonest Megyn Kelly "question" (previously the rage on right wing web sites) is so galling, and so dangerous, that it requires close attention:
1. This is not about waste or profligacy. The sole reason for the extra costs is because Ohio's Medicaid expansion proved so necessary and appealing that more people signed up than predicted. Do you catch that trick? Ohio's Medicaid expansion is not so vital and successful beyond expectations; No, it is "over budget." In other words, when Gov. Kasich [illustrative numbers only] originally hoped to reduce Ohio's uninsured rate by 5% in the first year, but wound up reducing it by 8%, that wasn't a striking success; it was an Orwellian failure to meet a budget. (Kudos for the dry accounting language of evil.)
2. Still, what about the $1.4 billion in extra costs? All of it, 100%, is covered by the federal ACA program, without any additional costs to Ohioans.
3. But Ms. Kelly mentions the "taxpayers"? Ohio taxpayers? No. She is slyly referring tofederal taxpayers. But the ACA federal taxes are already being collected, and they don't go up or down whether Ohio expands Medicaid, rejects Medicaid or enrolls more (or less) than they expected in Medicaid. If Ohio Republicans succeeded in taking away their citizens' insurance, federal taxpayers would not save a penny.
4. Sure, but after a couple of years Ohio taxpayers will have to pay 5% to 10% of this higher number? Two answers: (i) yes, but that was never the Republican objection. Republicans objected to paying 5% to 10% from dollar one, and falsely pretend that the problem was "billions" of unfunded costs. (ii) Much of the unexpected ACA Medicaid expansion consisted of former (traditional) Medicaid members learning that they are eligible for the new, expanded ACA Medicaid. Guess what? The Medicaid expansion is paid 90%-100% by the federal government, while the traditional Medicaid is paid around 50%. So, with respect to the "overage," Ohio is getting double the Medicare reimbursement by accepting Obamacare, and eliminating the (substantial but inadequate) amounts that it used to spend on the uninsured.
OK, that may sound wonky, but it is clear . . . and Megyn Kelly certainly knew what she was obfuscating. Sorry, Megyn. The politics of your Republican bosses remain immoral . . . historically immoral. A true journalist would report the crime, not aid in covering it up.
(BTW: just look at the language of her question - "You defended your Medicaid expansion by invoking God," you talk about "arriv[ing] in heaven," and "Saint Peter" and what we should do "for the poor." Megyn Kelly is most worried about defending the morality, not the economics, of the Republican position. Indeed, with typical chutzpah, she turns the question on its head and asks why Republican voters shouldn't "believe that you won’t use your Saint Peter rationale to expand every government program?" That is some nice old time religion they have.)