by James Wigderson
Special Guest Perspective for the MacIver Institute
Robert Mentzer, the opinion editor at the Wausau Daily Herald, is grateful that my op-ed last week for the MacIver Institute was free of “Obamacare = death of freedom” rhetoric, even as he finds my arguments opposing Medicaid expansion to be less than compelling. I’ll leave the cataclysmic rhetoric to Democrats like Senator Max Baucus and Senate Majority Leader Harry Reid who described President Barack Obama’s Affordable Care Act as, “a huge train wreck.”
In the critique I did of the proposal to expand Medicaid spending in Wisconsin to 133% of the federal poverty line, I pointed out that the federal funding for such an expansion is likely to be temporary while the so-called temporary expansion of spending is likely to be permanent. I even quoted House Budget Committee Chairman Congressman Paul Ryan as saying that such increased federal reimbursement would be, “The fastest thing that’s going to go when we’re cutting spending in Washington is a 100 or 90 percent match rate for Medicaid.”
In his blog response, Mentzer dismisses such pessimism, and even accuses Ryan of enjoying cutting federal aid to the poor. “Slashing discretionary spending on programs that benefit poor people is kind of Ryan’s thing!” he wrote in bold type. At least Mentzer also didn’t accuse Ryan of enjoying pushing granny off a cliff.
He also criticizes Governor Scott Walker’s health care reform as the product of presidential politics. “In order to avoid seeming to be heartless and unconcerned about the hundreds of thousands of Wisconsinites who will not get health coverage as a result of his decision to run for president…” My advice for Mentzer would be that if he’s truly interested in a substantial discussion of the proposal to expand Medicaid coverage, he should stick to questions of policy rather than demonizing those that disagree with him.
However, Mentzer has good news. He assures the reading public that “there would be no actual risk to Wisconsin taxpayers to taking the Medicaid match on a short-term basis,” again in bold type, because Obama will protect the Affordable Care Act with his veto pen until 2016. We’ll just file that with “if you like your insurance, you can keep it,” and the promise that families will see the cost of health care premiums go down.
Obama has already accepted changes to the Affordable Care Act, including the elimination of the tax on medical devices. Will Obama retreat on the other 18 unpopular taxes, such as the 40 percent excise tax on “Cadillac” health plans? Or the $55 billion tax on individuals who don’t purchase health insurance? What about the raid on Medicare? How will Obama pay for the “doc fix” every year?
If the current level of federal reimbursement is around 60%, then it’s not unreasonable to expect that Medicaid reimbursement would drop to that level again. The White House already proposed “a blended rate” for Medicaid reimbursement as part of Obama’s 2013 budget that would have shifted more costs to the states. They dropped the “blended rate” during the “Fiscal Cliff” negotiations, but that does not sound like Obama is going to defend Medicaid reimbursement rates with his veto when he has already proposed lowering them.
But despite Mentzer’s assurance that taking the federal money would only have to be short term, he concedes that the proponents of the Medicaid expansion are not thinking short term at all. He says this is a “hail Mary” position of those who wanted Walker to create a Wisconsin-based exchange. Why would they ever concede going to the governor’s plan once they got what they wanted?
So Mentzer and the Wisconsin Hospital Association would tie Wisconsin to a plan with what will likely be a temporary source of funding and a long-term funding obligation. Welcome back to the era of Jim Doyle budgeting.
Or we can adopt the governor’s plan. No wait lists. Badger Care would cover 100% of those below the federal poverty level. Meanwhile, an additional 224,000 people will have health care coverage. And if the health care exchanges aren’t ready, Walker’s plan will wait.
For all of Mentzer’s questioning of Republican motives, the more fiscally sound and compassionate plan is the governor’s plan.