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Sunday, Apr 20, 2014
Tom Jackson

Jackson: The worrisome “success” of Medicaid expansion

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You know the debut of the new federal health-care-law-turned-debacle (or maybe it’s the other way around) has been brutal when its supporters resort to cheering the spike in Medicaid enrollment as one of its clear, if unsung, successes.

In an attempt at management-by-media-manipulation Thursday, President Barack Obama scolded the White House poodle press for its failure to acknowledge the joy of the Affordable Care Act, or “Obamacare,” having added, in just 10 states, 444,000 to the lowest rung of America’s medical insurance ladder.

About that. Nevermind the 2010 landmark study by the University of Virginia indicating Medicaid patients often receive lousier care and experience worse outcomes than people with no insurance at all. Or that Obamacare’s squeeze on payments to providers will do nothing about increasing the number of doctors, clinics or hospitals accepting Medicaid patients.

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As far as “Obamacare” fans are concerned, this is a case of need seen, need vanquished ... not to mention we’re one step closer to single-payer.

At his rambling, occasionally incoherent Thursday presser — the one in which he granted kingly waivers for insurance companies to reinstate policies they’d canceled (good luck with that) — the president scolded reporters for their under-reportage. Nevermind that feeding Google “Obama, Medicaid, success” produces more than 28 million hits. Plainly, somebody’s been swilling the Kool-Aid, but the President seems to be as unaware of this propaganda wildfire as he was problems with the ACA website.

But finding joy in the Medicaid surge, largely made possible by boosting income eligibility, represents separation from reality in the extreme. It’s like celebrating the triumph of the stimulus by touting the millions of Americans still receiving unemployment checks 22 months after they were laid off.

Oh, wait. They partied on that “success,” too.

All of this stripped away any sense of the unexpected from Wednesday’s town hall meeting hosted by the Tampa Bay Health Care Collaborative. Those crowding the Medicaid expansion bandwagon can’t see past the $51 billion Obamacarrot dangling in front of the Florida mule, and they won’t be content until they’ve dragged the Legislature’s Republican leadership aboard.

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Nor were we remotely surprised to find Pasco’s new tax collector leading the argument. After all, the recent job switch of titular Republican Mike Fasano from state representative to constitutional officer is in no small way attributable to his relentless pursuit of new Medicaid dollars.

This just in: Moving Fasano out of Tallahassee did not extract his burr from under the GOP’s saddle ... and Fasano-blessed Democrat Amanda Murphy’s win in last month’s special election to succeed him was only an early example.

As ever, Fasano is guided by the impulse of a generous heart, guided by working-class roots. When he talks about “looking out for the little guy and little gal,” it’s in no small part because he grew up among them.

But if anything besides Washington’s inability to assemble and manage complex IT projects has been made clear since Oct. 1, it’s that “Obamacare” is the left’s fulfillment of a world-class wealth-transfer fantasy. Shifting the responsibility for who pays and how much is the fundamental propellant behind the rash of policy cancellations and soaring premium prices, and the belated revelation by left-leaning reformers that they’re on the hook is a schadenfreude-apalooza for clear-eyed conservatives who knew what was coming.

What Category 8 temblor shaking up the private insurance market pertains, as well, to Medicaid expansion, which adds $800 billion in projected federal outlays to a program already on rickety financial legs. In short, somebody has to pay for it, and given Washington’s history of fecklessness, the Legislature’s bosses — hat tip to House Speaker Will Weatherford of Wesley Chapel — are wise to be steadfast.

The early returns say “Obamacare” turns out to have been one big misdirection play, and now a substantial number of those who were for it are against it. Suppose the whole thing unravels. It’s possible. When that happens, it would be better not to be in the shoes of states trying to wriggle out of an ironclad entitlement that arrived on a tissue of bad information and insupportable promises.

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