By Greg George
Last week, the Michigan House of Representatives voted 76-31 in favor of Medicaid expansion. Twenty-eight Republicans joined all but one Democrat in the vote for passage of HB 4714. The charge was lead by Rep. Mike Shirkey (R-Clarkston), who thus justified his vote:
“There are perfectly good legitimate reasons to oppose” but “sound, reasonable reasons to support” Medicaid expansion.
What is the most compelling reason to oppose Medicaid expansion? It’s a one-way street: Expansion won’t come without a huge price tag, and opting-out in the future will be very difficult, if not impossible.
And what is the most compelling reason to support expansion? According to Gov. Rick Snyder, Medicaid expansion is about helping citizens access affordable care.
But opposing Medicaid expansion is not about keeping the poorest of the poor from good, quality health care. That is exactly the intention of Medicaid and exactly what it attempts to do right now. Unfortunately, the system is unaffordable and broken.
At the state level, Medicaid spending in Michigan increased 65% from 2000-2010 and continues to consume the state budget. At the federal level, Medicaid waste, fraud, and abuse hemorrhage tens of billions of taxpayer dollars every year.
The main way states control increased state spending for Medicaid is by slashing reimbursements to physicians and other providers. Because Medicaid pays physicians only about 60% of what private insurers do, Medicaid recipients often have a difficult time finding a doctor who accepts Medicaid patients. Nearly one third of physicians now say they would not accept new Medicaid patients.
If lawmakers at the state and federal level were serious about providing better coverage and care, they would start with requesting more control of the Medicaid dollars. This is really what Medicaid opposition is about: fighting for the most vulnerable to be in more control of their health care.
How is it humane to expand such a system that provides such poor results?
Furthermore, health outcomes for those on Medicaid have been shown to be no different than those without insurance. Increases in coverage, usage, and diabetes detection did occur along with reductions in financial strain, but this would absolutely occur without expansion and reforms to the current system. Providing more control to those currently on Medicaid will save the state money and improve care. Just as reforming welfare during the 90s did.
Michiganders deserve access to affordable and high-quality health care. Historically, the only way to accomplish both of these objectives has been to make health care patient-centered, not government-controlled. Politicizing health care is exactly what Medicaid expansion and ObamaCare do, because they put government at the center of health care. Shouldn’t patients be at the center of their own health care, and shouldn’t the poorest of the poor also have that option?
Even with the proposed reforms in House Bill 4714, coverage under the new health care law is defined not by individuals or doctors, but by government bureaucrats at the U.S. Department of Health and Human Services. Expanding our current health care system with thousands of pages of regulations (aka imitations) that say “must” or “should,” do not provide the necessary mechanisms to make health care better and more affordable.
Opponents to expansion argue that implementation of this law as written is not inevitable and considering that more than half of the American people oppose the law, it is improbable.
So the question at hand in the upcoming Senate vote is this: Will Michigan resist a centralized government approach to health care reform and instead focus on solutions that make health care more affordable and accessible for every American, or will legislators burden future generations with less prosperity and more debt?
Greg George is the Government Affairs and New Media Associate. Greta Pisarczyk contributed to this article. Follow @gregmgeorge and @pisarczy.