States resisted initial Medicaid program, too
Barb ShellyGovernors said “no way.” State legislators swore they wouldn’t touch the stuff.
Federal money, that is. To pay for health care for low-income Americans.
The year was 1966 and the federal government had just enacted the original Medicaid program. Participation by states was voluntary, and leaders in many parts of the country were deeply skeptical about taking on their share of the program.
But a year after the federal matching share became available, 26 of the 50 states had signed on. Within four years, every state except Alaska and Arizona were participating in Medicaid. Alaska came aboard in 1972. Arizona yielded in 1982 after citizens petitioned the state legislature, complaining that their federal tax dollars paid for Medicaid, and they ought to be receiving some benefits from it.
Almost 50 years later, resistance to a Medicaid expansion under the Affordable Care Act runs high in many state capitals, including Missouri and Kansas. But the experience of the original Medicaid program, and also of the Children’s Health Insurance Plan, which expanded coverage to low-income children, suggests that full participation may be only a matter of time.
It’s hard to defend holding out when other states are reaping major economic development benefits from federal Medicaid payments and citizens elsewhere are healthier and more secure.
As I noted in this column, the Affordable Care Act offers a potent incentive for states to jump in quickly. The federal government will pay 100 percent of the costs of the expansion in the 2014, 2015 and 2016 fiscal years. People who have gone without insurance and then get into a plan tend to be heavy users at first. They’ll see doctors for preventive care and have long-postponed surgeries such as knee replacements. So states want to get people into their insurance networks while Washington is picking up the tab.
Republican legislators in Missouri and Kansas, and maybe Kansas Gov. Sam Brownback as well, think they can still derail the Affordable Care Act by holding out. But chances are they’ll only hurt their own constituents and their states’ bottom lines over the long run.
More about states’ role in the start of Medicaid can be found in this Washington Post story and this paper from the Kaiser Commisison on Medicaid.
Mark Robertson
5 months, 3 weeks agoStates were right to resist Medicaid in the 60s, and of course they have proven to be totally correct. Medicaid is a disaster. More and more doctors are refusing Medicaid patients because they can’t stay in business because of the inferior reimbursements. That is how soicialized health care always works, costs surge out of control, and services deteriorate. The poor were better off before Medicaid. The year prior to introduction of Medicaid, poor families had higher hospital admission rates than did wealthier families. Also, high income individuals had an average of 5.1 doctor visits a year, compared to 4.3 visits by low income individuals.(The Politically Incorrect Guide to American History, by Thomas Woods Phd. A health care system that was already working, p218) And it would be laughable if it weren’t so pathetic to say that Federal government will pay for total Medicaid bill for 3 years. They won’t, but what happens after that? You libs never think down the road. And our country won’t survive Obamacare. It is a catastrophe nearly beyond words. The states should stand strong against the insanity of expanding the failed Medicaid program, and the states should continue to resist Obamacare. Those states that do will have an economic advantage for a number of reasons. Businesses would be attracted to them because they wouldn’t have to deal with the oppressive, costly Obamacare. And states would of course save much money. Like the great Ronald Reagan did to Communism, the Republicans and sensible Democrats should relegate Obamacare to the ash heap of history. Thankfully there a number of great Republican governors, such as the outstanding Sam Brownback, who will not allow the madness of Obamacare into their states. They and the Republican state legislatures are the last line of defense against the tyranny of socialized health care. Thank you. Mark Robertson Independence
George Hunsucker
Northland
5 months, 3 weeks agoOnly a ms. shelly would characterize medicaid as a program that should be embraced… when will libs such as ms. shelly wake-up to reality I wonder?????