Obamacare’s Medicaid Expansion


HealthcareNever write or speak on something you have an opinion on from reading and listening to others, but not through any particular research. That is the way I feel about Obamacare’s Medicaid expansion. I know it affects me and my family. I know it affects Utah’s State budget. And I know it affects other Utahns. I know just enough to be dangerous. Maybe it is an affirmation towards our form of Representative government.

Since pioneer days, Utahns have valued self reliance. The most fascinating part of the Medicaid expansion debate for me is that in all the media articles on the subject, the discussion in context of self reliance is absent.

“Give a man a fish and he eats for a day. Teach a man to fish and he eats for a lifetime.” (proverb)

In addition, most believe in a safety net for those who simply cannot provide for themselves. There is a ongoing battle between conservatives and liberals about where that net should be. But this is a real part of Medicaid expansion and needs to be considered.

My understanding is that Obamacare attempts to cover people up to 100% of what is considered poverty, but there are donut holes where some are left out. I’ve heard the example of the single mother who works two close to minimum wage jobs who can’t afford health insurance and isn’t covered. Her children are covered, but she isn’t. How do we extend coverage to her, who is trying to be as self reliant as possible? Or maybe there is a person who is medically frail, who is unable to keep a steady job, but doesn’t qualify. How do we help them?

Those from 100% to 138% of poverty have many more able bodied adults who could be covered by expanding coverage for Obamacare’s Medicaid. We may actually be providing an incentive for them to stay in this economic status instead of finding a higher paying job.

Why don’t we help those who can’t help themselves or are already making an extraordinary effort to help themselves, but not give coverage to able bodied people who instead should be helped to gain the skills necessary to find better paying jobs.

Beyond the actual coverage, the bogeyman in the room is the overreach of the federal government. Over time, States have gradually given up their decision making ability as a result of taking the strings attached to federal money. Those strings then force us to do things we wouldn’t choose ourselves. In education, No Child Left Behind is a good example. But in just about every nook and cranny of State government, there is federal government money dictating policy to the State of Utah. Should we accept these funded mandates? Some say Utah is just getting back some of the money our citizens sent in the first place. But the strings subjugate us to the feds.

Remember William Wallace in Braveheart when tortured at the end of the movie he yells, “Freedom”. A bit overly dramatic, but the principle is the same. There is huge value in maintaining our independence from federal mandates.

Ronald Reagan said, “Government is like a baby. An alimentary canal with a big appetite at one end and no sense of responsibility at the other.” News flash: our federal government is over $17 trillion in debt.

There is no end in sight to continued overspending. Laws of basic finance tell us that over time we can’t rely on the federal government to keep their obligations.

So all that free money for Medicaid Expansion isn’t free. In the long run it gets Utah hooked on an unsustainable program. And worse, it may hook individuals on an entitlement that hinders their self reliance.

Another Reagan quote, “No government ever voluntarily reduces itself in size. Government programs, once launched, never disappear. Actually, a government bureau is the nearest thing to eternal life we’ll ever see on this earth!

Once we embark on the Medicaid expansion tracks, there is no going back. Utah policy makers should be very careful before getting on board this train

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