Arizona is forging ahead into Medicaid expansion, facts and history be damned.
Governor Jan Brewer unexpectedly came out in support of adopting this major part of the Affordable Care Act (ACA) earlier this year–despite how much she seems to relish the role of foe to President Obama. Now, Brewer and others in the state senate are trying to rush the measure through the state Senate.
Putting political grandstanding aside–something desperately needed in the Medicaid expansion debate–it becomes clear that Brewer has nothing to stand on. Arizona already has a history of failed Medicaid expansion. This occurred in 2000, when Arizona had a federal waiver to do so. John Davidson, health care policy analyst at the Texas Public Policy Foundation writes:
At the time, Arizona lawmakers and expansion advocates promised that expanding Medicaid would lower the uninsured rate, reduce uncompensated care costs, decrease the “hidden tax” on private insurance for uncompensated care, and save about $30 million a year in state funds.
These same promises — lower uninsured rate and reduced uncompensated care costs — are being made by those calling for Medicaid expansion in other states.
None of the promises came true. In fact, the opposite happened. Enrollment of parents was more than triple what was forecast, while enrollment of childless adults was more than double.
As a result, costs skyrocketed. Spending per enrollee was much higher than anticipated, especially among childless adults, who proved to be twice as expensive to cover as parents. By 2008, Arizona had spent $8.4 billion on Medicaid expansion — more than four times what had been forecast.
By doing this, Arizona has trapped itself into this massive liability, yet it is still planning to take on an even larger one. All the while, the state already relies heavily on the federal government to fund its overall budget: State Budget Solutions found that federal aid pumps up a shameful 45.7 percent of Arizona’s budget. That puts Arizona in third place, behind only Mississippi and Louisiana.
Never mind that Medicaid expansion does little to actually improve health outcomes of state residents. This was already debunked in the Oregon study published in the New England Journal of Medicine. Medicaid is broken and needs fixing before it can be expanded.
Governor Brewer thinks that she sees reliable federal funds on the other side of the hill, but it’s really just a desert mirage.
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