Medicaid expansion is a bad deal for Georgians by Kyle Wingfield, AJC. The word you are groping for is "chutzpah".
Wingfield’s analysis reminds me of the teenager who kills his parents and then begs the court to show mercy because he is an orphan. According to Kyle, huge problems would result from accepting federal funds to expand Medicaid. There are two roots to this potential calamity: the fact that provider payment rates for Medicaid are low and the fact that federal government might someday reduce federal spending on Medicaid.
He’s half-right on each count. Both of these two factors could complicate a Medicaid expansion in Georgia. But for each factor, there’s something important he’s leaving out. Medicaid provider payment levels in Georgia are determined by Georgia lawmakers. They could, and certainly would, be a lot higher if the members of the Georgia wing of Wingfield’s own political tribe allowed them to be. On the other hand, federal lawmakers will determine the federal contribution for Medicaid costs. And that contribution will only be reduced if the members of the national wing of Wingfield’s own political tribe allow that to happen.
Seriously, does anyone think that It’s Georgia Democrats who keep Medicaid provider payments in Georgia low? Or, nationally, that anyone other than Republicans is likely to call for reducing Medicaid spending? So, the two problems Wingfield sees in the Democrats’ Medicaid increases both boil down to the fact that Republicans have worked and will continue to work for Medicaid decreases.
Kyle Wingfield, I ask you: do you favor increasing Medicaid provider payments in Georgia? Do you favor maintaining the federal Medicaid percentage and spending levels found in current law? Or will you and your GOP tribe go on complaining, like the orphan who killed his parents.
For less than $2000 per newly insured person per year, Georgia can provide health insurance for every one of its low-income citizens. Great for the newly insured. Great for public hospitals. Great for the insured, who are freed from cost-shifting. Great for public health, as poor communities will cease being incubators for diseases like tuberculosis. A great deal for Georgia.
Update 7/14/12. I’ve changed the link so that it points to a comments page with some back and forth between Wingfield and Ragbatz concerning how Georgia’s participation in the litigation was financed. Wingfield had said that for Georgia it was all done by private lawyers acting “pro bono”; I don’t consider paying cash in part, but mostly piggy-backing on the litigation dollars and effort of a political action organization with a specific financial interest in the litigation as being “pro bono”. He had the last word and you might find it interesting.
One more aspect of the main body of his column has caught my attention. He proposes that Georgia might get a different deal by holding out. But what Wingfield identifies as possible better deals, block granting Medicaid or a complete federal takeover, are nonresponsive to problems he identifies in the article. Since low provider payment rates are entirely the result of decision by Georgia lawyers, block grants will likely produce exactly the same low provider payment rates. And, if the problem is that the federal Medicaid effort might decrease, that factor also persists under either block granting or federal takeover.
I think it pretty clear that the only problem Wingfield actually wants to solve is that the ACA might succeed.
Update 7/19/12. Well, I couldn’t let him have the last word on this “pro bono” BS, so see additional comments on his blog. Based on his very next column (on, as if you could not have guessed, “you didn’t build that”), I doubt I will bother again with “the AJC’s thirtyish conservative columnist”.
