Tuesday, November 27, 2012

Walker's Appearance of "Thoughtful Deliberation" Hoax...on Medicaid Expansion.

Come on, let's stop acting like Gov. Walker is actually considering an expansion of Badgercare (Medicaid), with a chance he might just do that. Not a chance.

By not adopting the expansion, costs will rise, and feed into the GOP meme that government spends too much. When in fact, Walker could have saved the state money and insured more people.

According to the latest research by the Kaiser Family Foundation, Wisconsin is on a course to save money from the expansion due to the Affordable Care Act (ACA), create jobs, help hospitals recoup uncompensated costs, and most importantly, save lives. The charts tell the story, along with selected passages below. Now you'll know more than any of our Republican state politicians:

click to enlarge
If all states implement the ACA Medicaid expansion, the federal government will fund the vast majority of increased Medicaid costs.  The Medicaid expansion and other provisions of the ACA would lead state Medicaid spending to increase by less than 3%, while federal Medicaid spending would increase by a 26% increase. 
Because Wisconsin has been on the cutting edge of coverage, a bragging point ironically made by Republicans, we’ll actually save big money:
Some states will reduce their own Medicaid spending as they transition already covered populations to the ACA expansion. States with the largest coverage gains will see relatively small increases in their own spending compared to increases in federal funds.
A potential problem for state’s who refuse to expand coverage based on ideology:
Even without the Medicaid expansion, Medicaid enrollment will increase due to provisions in the ACA that will lead to increased participation among those currently eligible for, but not enrolled in, Medicaid and CHIP (including children). If no states expand Medicaid, Medicaid enrollment would rise by 5.7 million people, and the number of uninsured would drop by 28%.

The incremental cost to states of implementing the Medicaid expansion would be $8 billion from 2013-2022, representing a 0.3% increase over what they would spend under the ACA without the expansion.
Saving taxpayer money is not the point of Republican politics; power and their belief system is all that matters. Even if Wisconsin spent just a little more, although the charts here assume we’ll spend less, the dollars saved on uncompensated payments is huge. And businesses like hospitals will increase their revenues, creating jobs:
States as a whole are likely to see net savings from the Medicaid expansion.  Combining Medicaid costs with a conservative estimate of $18 billion in state and local non-Medicaid savings on uncompensated care, the Medicaid expansion would save states a total of $10 billion over 2013-2022, compared to the ACA without the expansion.  Net state savings are likely to be even greater because of other state fiscal gains that we could not estimate based on 50-state data.

We also examine state costs given possible savings in other areas and in the context of state budgets as well as effects on hospital revenue … Medicaid coverage to individuals with incomes above 138% FPL could transition this coverage to Health Insurance Exchanges whether or not the states implement the Medicaid expansion.  If these factors were taken into account, many more states could realize net fiscal gains. 
These results vary considerably by state and region (Figure 8 above). Most of the net reductions in spending are in New England and Mid-Atlantic states (Wisconsin), many of which provided relatively generous preACA eligibility and consequently benefit from the increased federal match for current eligible … Overall savings in the New England and Mid-Atlantic states (Wisconsin) average 4.6 percent and 4.2 percent, respectively.  

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