Medicaid Expansion: Adding Passengers to the Titanic

NBC 17 reports on the Durham City Council approving a resolution to urge Gov. McCrory and state legislators to change their decision to reject Medicaid expansion. A local group of medical care providers also held a press conference delivering the same message. The Council and protesters appeared to be fixated on the theme that rejecting the Medicaid expansion equated to somehow “denying” health care to some 500,000 people – the estimated amount of new Medicaid enrollees that would be added if NC accepted the expansion.

However, here are some facts that the folks clamoring for Medicaid expansion overlook:

• The federal government covers the cost of the new enrollees for only the first three years. But where would they get the money? Some estimates put the cost of expansion nationally at $118 billion over the next decade alone. If you haven’t noticed, the federal government is broke.
• After the first three years, states would begin to pay a share of the additional costs. Some estimates place the cost of expansion to North Carolina at more than $3 billion over the next decade (these are likely very low). Where would the state get the money? State Medicaid spending has already shot up 42 percent in the last decade.
• Who will see the half a million new Medicaid enrollees? During a recent 8-year span, the state added 600,000 Medicaid enrollees, a whopping 50% increase in Medicaid patients. At the same time, the number of physicians accepting Medicaid patients decreased. The Medicaid system is already overcrowded, with enrollees having very limited access to actual medical care. What would happen if we jammed another half a million people into this program? That would be more than a million additional people crammed into a system chasing fewer doctors. Imagine adding a population roughly equivalent to all of Wake County into a system with already nearly 2 million people, all competing to see a dwindling number of doctors.

The bottom line is this: those advocating for Medicaid expansion want to condemn low-income people into an already overcrowded system that is simply incapable of providing adequate medical care. That’s not compassionate – that’s cruel.