Krugman on the stupidity of rejecting Medicaid expansion

Cutting off your nose to spite your face:

And why would they do this? They won’t save money. On the contrary, they will hurt their own budgets and damage their own economies. Nor will Medicaid rejectionism serve any clear political purpose. No, the only way to understand the refusal to expand Medicaid is as an act of sheer spite. And the cost of that spite won’t just come in the form of lost dollars; it will also come in the form of gratuitous hardship for some of our most vulnerable citizens.

There really isn't any sensible reason to do this. It's apparent that nobody did a cost/benefit analysis of rejecting expansion, it was just a knee-jerk reaction. And we will all pay the price for that poor leadership:

“Extending eligibility for Medicaid will not only insure 500,000 North Carolinians but also create jobs in the most rural areas of our state,” said Adam Searing, director of the North Carolina Justice Center’s Health Access Coalition. “Medicaid coverage will turn uninsured people walking into emergency rooms seeking care from overburdened hospitals into patients with health coverage who are seen at health clinics before minor problems become serious.”

Medicaid expansion saves money for all North Carolinians who buy health insurance. The American Academy of Actuaries estimates that premiums for private insurance will be at least 2 percent higher in states that do not expand Medicaid, due to cost shifts and unhealthier people buying subsidized insurance. Because the Medicaid expansion is paid for three years entirely by the federal government, this expansion can be enacted at no cost to the current state budget.

If North Carolina chooses not to expand Medicaid using 100 percent federal money, that federal funding – already appropriated by the Affordable Care Act – simply goes to other states like Arizona and New York that are expanding their Medicaid programs to enable them to be more efficient and effective.

It's downright embarrassing that NC lawmakers only try to emulate the bad ideas coming out of Arizona, while ignoring the few ideas that make sense. Back to Krugman:

A new study from the RAND Corporation, a nonpartisan research institution, examines the consequences if 14 states whose governors have declared their opposition to Medicaid expansion do, in fact, reject the expansion. The result, the study concluded, would be a huge financial hit: the rejectionist states would lose more than $8 billion a year in federal aid, and would also find themselves on the hook for roughly $1 billion more to cover the losses hospitals incur when treating the uninsured.

Meanwhile, Medicaid rejectionism will deny health coverage to roughly 3.6 million Americans, with essentially all of the victims living near or below the poverty line. And since past experience shows that Medicaid expansion is associated with significant declines in mortality, this would mean a lot of avoidable deaths: about 19,000 a year, the study estimated.

Just think about this for a minute. It’s one thing when politicians refuse to spend money helping the poor and vulnerable; that’s just business as usual. But here we have a case in which politicians are, in effect, spending large sums, in the form of rejected aid, not to help the poor but to hurt them.

That's because the only skills the NC GOP has are destructive in nature. They're like a wrecking ball. They have no purpose until the Democrats build something, and then the ball starts swinging back and forth. And they don't care if there are people still inside those condemned buildings.


I wouldn't trust R's to set up an exchange anyway.

As much as they crow about being business minded models of citizenry, this boneheaded refusal to reject Obamacare proves they don't do math well.

They are Blinded... their hatred of Obama. State and Federal tea party nuts will throw citizens under the bus just to prove that they're wing nuts who hate Obama.

Wrecking ball is absolutely right.

"I will have a priority on building relationships with the minority caucus. I want to put substance behind those campaign speeches." -- Thom Tillis, Nov. 5, 2014