As the legislative session approaches one of the most pressing issues we’re facing is a provision under the Affordable Care Act, Obamacare, regards Medicaid expansion.
It provides that anyone earning up to 138 percent of the poverty line would now qualify for Medicaid if the state accepts the provision. In addition, the federal government would pay for 100 percent of coverage the first three years and 90 percent the next two. Currently the state of Wyoming pays for 50 percent of the cost of Medicaid and will continue to for those under 100 percent of the poverty line.
There is a lot of lobbying going on about whether the state should accept this provision or not. Those who would qualify are, for the most part, obviously for it and are imploring we legislators to vote for it. We are being characterized as mean-spirited and hard-hearted for not immediately agreeing to provide “free” health care.
But nothing is free and I think the consequences should be considered.
The first is on the federal level. How are we supposed to pay for it? The federal deficit is already at dangerous levels and this expansion can only balloon it up. The talking point that Obamacare would reduce the federal deficit was as specious as “ If you like your health plan, you can keep your health plan.”
The next concern is on the state level as expressed by Gov. Matt Mead. What happens in five years when the feds stop paying the 90 percent they’ve promised? The state will be on the hook for the full 50 percent of the entitlement. Each year when the Legislature meets, the largest item already requiring a budget increase is always Medicaid. What happens when you increase 17,000 people to that total?
Revenues from the energy sector are already flat and they don’t look to improve in the foreseeable future. Where are we supposed to find the money? It’s a demographic time bomb we’re saddling ourselves with in the near future.
My third and, perhaps, largest concern is local. What’s the effect on our local resources? Currently, Sheridan Memorial Hospital economically survives by cost-shifting. They over-charge private insurance to cover the shortage in reimbursement from Medicaid and Medicare.
In fact, Medicaid only covers about 71 percent of what it costs the hospital to treat it’s patients. With a large increase in Medicaid patients where is the hospital supposed to find the funds to offset the increased costs? In addition, with so many people losing their current health care plan under Obamacare the private insurance pool of money is actually shrinking.
The Association of Hospital Administrators predict more than 1,000 hospitals will close in the next few years because of Obamacare. Sheridan is blessed with excellent medical resources and I think we should be very careful before sacrificing the good in hopes of the perfect.
Sen. Bruce Burns is a state senator for Sheridan County.