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HEALTH: Take care with Medicaid expansion

Letter by Marilyn Martinetto, Steilacoom on June 28, 2012 at 1:45 pm with 3 Comments »
June 28, 2012 1:59 pm

The Supreme Court upheld the health care law. States will begin implementation. States will also decide whether to expand state Medicaid rolls.

The ruling permits states to opt out of that expansion without losing all federal Medicaid supplemental funding. Some states will decide whether to expand solely on ideological grounds with conservatives opposing and liberals supporting.

The decision must instead be made by each state based on its ability to raise revenues to support expansion according to its taxpayers’ ability to pay that revenue. Further, that ability-to-afford decision must consider the future when federal funding of Medicaid expansion declines.

States must also look beyond existing state population. States must concurrently strengthen state residency and eligibility requirements to avoid a massive influx of people who’ll lack the same Medicaid coverage in their states.

Usually home ownership and good jobs prevent many people from moving when they’d like. Many who lack both can and do move frequently to find jobs or to obtain public benefits.

California is an example. Once a rich state with high employment and a population of talented people who voted themselves generous unemployment and welfare benefits, from the late 1950s onward it’s become a magnet for people from states lacking jobs and meager public welfare benefits. And it’s experienced a massive exodus of the middle class unable to keep up with the resulting tax burden.

California today is a state of some very rich and many low income, unable to pay obligations, divided in wealth and politically polarized.

Leave a comment Comments → 3
  1. taxedenoughintacoma says:

    Marilyn, excellent letter.

    We will go in the direction of Calif. if we don’t change the political majorities of this state.

    I hope reasonable people remember your letter before they mark their ballot.

  2. “Ewwww, if Dems are elected, we will have insurance coverage for poor people, and all those icky poverty-stricken folks will move from Mississippi to Washington State just to get medical coverage.”

    The US Supreme Court found that “the empirical evidence suggests that so few move to a new state to receive higher benefits that there is no basis for burdening those without such a motive.” And the state they used as an exampole was California, the state with the highest number of people moving into the state who had been on welfare in a previous state when they moved. In 1999 it was 2,022 people and averaged about 1,800 people. The highest benefit states saw less than .01% increase in a ten-year period of people coming from a lower-benefit state.

    The Center for Law and Justice found that poor people receiving “welfare” benefits seldom move from their current state because they cannot afford such a move.

    That blows one big mythological basis of your fear-ridden letter.

    The other fact is that we already pay for medical coverage. The Medicaid expanded insurance system with access to routine and preventative care will cost less than the emergency room care we now provide.

  3. In addition, most states have a residency requiremet.

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