Medicaid expansion higher than expected, spells doom for enrollees
Who could have seen this one coming?
Medicaid expansion under Obamacare is 91 percent higher than states expected.
Of the states initially choosing to expand Medicaid under Obamacare have seen enrollee numbers explode from an estimated 3.6 million to nearly 7 million, a whopping 91 percent increase.
Remember the Tennessee Medicaid expansion in the early 1990s that resulted in 300 percent debt above expected costs and enrollment shoving the state into near bankruptcy, a failing credit rating, a near state income tax and consumption of nearly 40 percent of the states total budget?
The end result in TN, the Governor had to cut 10s of thousands of enrollees from the roster of TNCARE enrollees just to stop the bleeding.
The trouble with “free healthcare” under a state plan via Obamacare is exactly that, it’s free!
If you throw out a free state program via the federal government to those who unfortunately have very little, it will be ravenously and uncontrollably consumed. Consumed much like a wild animal being thrown a steak.
You can stand at any Emergency Room in the nation and see the waste and over utilization inside a free, expanded healthcare program. The doors are brimming with consumers trying to get a chunk of that free healthcare pie.
The continual rotation of these patients night after night, day in and day out is only understood by a caregiver that works in this environment.
The system has no checks and balances and does not encourage frugality nor discourage habitual practices and use of the ER as the main source for their primary care.
Costs will continue to sore and few will restrain. At this pace it is easy to see private healthcare premiums will continue to rise and their benefits dwindle because free healthcare will consume all the resources.
This allowance for overspending seems purposeful. This seems to stimulate the record high healthcare CEO salaries among Insurance executives. This would explain loads and would definitely explain the lack of oversight of such a massive expansion.
The hospitals are at an advantage here and are calling for expansion to tap into the steady stream of federal tax revenue to protect their bottom line. Sadly, this only kicks the can down the road and doesn’t solve our current problem the one we initially set out to fix.
Hospitals are reluctant to discourage utilization instead preferring to overutilize to maximize a return on the care rendered while never really expecting to get 100 percent of their costs recovered. They are simply tossing out the net and recovering as much revenue as possible to stay alive.
Our healthcare system will never be fixed by encouraging frugal utilization because lower billable costs will result in lower income streams, thus our dilemma and conclusion that healthcare cost will never be reduced because to reduce or manage costs downward will spell financial disaster for those delivering that care. We have to lower costs inside the machine and decrease that demand which would offer incentive to restrain spending. Attacking Big Pharma costs for medication cost crimes would also be a sensible maneuver if we truly want to knock down escalating costs.
There is no incentive not to consume or penalty for doing so inside our healthcare system for the reasons aforementioned.
The free fall begins and will continue if certain legislator have their way.
We are not fixing anything by expanding Medicaid or introducing INSURE TN, ie, Obamacare to the masses we are only perpetuating the delivery of 100s of million of new federal tax dollars and dumping them on a huge healthcare sponge that has no restraint nor does it encourage restraint.
It’s paradoxically the same as giving a heroin addict a syringe and endless supply of cash and telling him to be thrifty with it’s use.
The recipients of free healthcare see this as an entitlement and under these conditions cost control will not happen nor will over consumption be squelched.
Costs will inevitably be beyond state budget restraints and many will eventually receive benefits and then have them taken away when states realize they can’t support the weight of a continuous drain on it’s resources.
Remember the Affordable Care Act, Insure TN, Medicaid expansion was to be sexy beast designed to entice 100s of thousands into free healthcare with the promise of federal aid to cover 100 percent of the costs of the new enrollees. The ugly, not so sexy side is, the federal government is not refunding 100 percent as promised.
In 2017, the federal government’s portion of the bill will start scaling back, eventually down to 90% and then as if to add insult to injury, the states are on the hook for 50% of the administration costs incurred in signing up new Medicaid enrollees.
For example, In Kentucky, they had 311,000 new Medicaid enrollees in fiscal year 2014, doubling their original estimates.
Kentucky is now being forced to revise its Medicaid cost estimate from $33 million to $74 million for fiscal year 2017, and the projection for 2021 is now a staggering $363 million.
Kentucky will be forced soon to remove many from it’s enrollees from their insurance plans as Tennessee did in the 90s after over enrollment and cost factors proved too much for the states budget.
Please see the graph below provided by FGA, the Foundation for Government Accountability.
As per the graph above it shows “17 states were over their projected 2014 enrollment, and 16 states had already enrolled more than they projected for the lifetime of expansion.”
As per uncoverobamacare.com, “According to an AP analysis of state budget projections, at least 14 states have new Medicaid enrollments that have exceeded their original projections, Medicaid enrollments, and cost details in the expansion states. At least seven have increased their costs estimates for 2017 like Kentucky had to do.”
The AP report continues, “California had enrolled nearly 2.3 million people, almost three times what they estimated. Washington’s enrollment more than doubled. Oregon’s enrollments are 73% higher than projected. Michigan’s estimated costs increased by 50%. Ohio’s projected costs more than doubled!”
As you can see we are fixing nothing by expanding Medicaid, implementing Insure Tn or Obamacare.
We are only enabling the demise of a system crippled by many years of overspending inside an anemic reimbursement structure.
We have created the monster, now it’s time to tame it, if we dare.
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