Medicaid Expansion is About Priorities

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Via John Micek, Tom Corbett is finally sharing his feelings about the Medicaid expansion:

MEDICAID EXPANSION: Corbett spun out three scenarios for the expansion of coverage mandated in the federal healthcare act: No expansion; limited expansion (100 percent of federal poverty level) and total expansion (coverage to 130 percent of poverty). If everyone eligible for coverage sought it, it would cost the state $134 million in FY 13-14. A limited expansion would cost $178 million and full expansion would run to almost $222 million in the next budget year, growing to $4.7 billion by 2021, he warned. Social service and Medicaid spending comprises about 39 percent of the current budget.

The Republicans are going to try to convince everybody that “we can’t afford it” but that’s nonsense. The federal government is paying 100% of the cost for the first 3 years, and then scaling back their contribution to 90% after that.

To put it in perspective, the state budget this year was $27.7 billion. I don’t know what all Corbett is including his $4.7 billion figure, but spread out over an 8-year span that just isn’t very expensive.

It could easily be achieved through a combination of economic growth, a small tax increase, and cutting weaker claims from the budget. For instance, PA spends $260 million annually on a Horse Race Development Fund. Personally I think $0 is the correct amount of public money to spend on horse race subsidies, and the case for $0 on horse racing is even stronger when the trade-off is expanded health insurance for human beings.

There’s plenty more where that came from. That’s how the Medicaid expansion debate needs to go down. Republicans want to debate a strawman, where it’s Medicaid expansion vs. $4.7 billion tax increase.

Democrats need to be pointing out that there are weaker claims in the budget to cut, that a small tax increase would be worth expanding insurance coverage, and that if Republicans are really concerned about the cost, we can easily do this cheaper by adopting Maryland’s price controls, aka All-Payer Rate Setting.

This entry was posted in Budget, Health.

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