In the midst of the Virginia General Assembly's failure to pass a budget before session ended, a coalition of Virginia business groups and hospitals have launched a campaign to expand Medicaid in the state. "A Healthy Virginia Works" and state chambers of commerce have launched a website, Facebook and Twitter pages, and a radio ad to promote Obamacare's Medicaid expansion in Virginia.
The radio ad can be heard here:
"Virginia lawmakers are wasting $5 million a day. It's tax money we're already paying to Washington to support Obamacare. Frankly we need to get our money back."
In the simplest of terms, this campaign is a farce. It lies about the direction of tax dollars and Obamacare without explaining the truth about costs in the off years.
First, this is not a private option.That should be abundantly clear by the fact that the ad demands that we take $5 million "back" per day from the federal government. If your plan begins by using federal tax dollars to fund expanding services, it is not private. It's exactly what was envisioned by the President when Obamacare passed in 2010.
Proponents of Medicaid expansion may throw out a grab bag of terms endearing to conservatives like "private option" and "free market-based alternative" but a reliance on federal money exempts you from being defined as "private."
Second, expanding Medicaid will not save Virginia money in the long term. State costs will grow faster than state savings. As we have explained before, cost per enrollee has increased 6% per year, an unsustainable rate of compounded growth with significant impact on the state's budget.
Medicaid will continue to be an ever-growing burden to the state, especially when the federal match shrinks, which will happen as a matter of law. Also, don't forget this warning from Congressman Paul Ryan (R-Wisc.): “The fastest thing that’s going to go when we’re cutting spending in Washington is a 100 or 90 percent match rate for Medicaid. There’s no way. It doesn’t matter if Republicans are running Congress or Democrats are running Congress. There’s no way we’re going to keep those match rates like that.”
If Democrats are genuinely concerned about the working poor in the state, they should work with Republicans to bring down the cost of health care in Virginia. Medicaid does the opposite and provides sub-par coverage in the process.
Hospitals concerned about their bottom line should be also be working with Republicans to repeal Obamacare, not expand the very program that is hurting business. Disproportionate Share Hospital (DSH) funding is being reduced as a result of Obamacare and working to make taxpayers foot the bill for the difference may partially explain the motive behind this campaign.
Either way, Republicans would be wise to reject attempts to categorize any plan that uses tax dollars as a "private" or "free market-based alternative" to Medicaid expansion.