Politics is about control. The more areas of society that are politicized, the more control the political class lords over its citizens. Everything from education, to healthcare, to energy, to transportation, to commerce to aid for the needy have become highly politicized. Citizens have become excessively dependent upon the government to provide for these services.
The best way to exercise control over people is to make them dependent upon you. Which brings us to this week’s Bad Bill of the Week: House Bill 1073, Expand Medicaid Eligibility.
Sponsored by Reps. John Ager (D-Buncombe), Verla Insko (D-Orange), Pricey Harrison (D-Guilford) and Susan C. Fisher (D-Buncombe), this bill would expand Medicaid in North Carolina as laid out in Obamacare.
These bill sponsors would likely claim publicly that Medicaid expansion would be a compassionate measure to provide health insurance coverage to low-income citizens – roughly 500,000 of them, according to the bill.
But the raw truth is that this would make half a million more North Carolinians substantially more dependent on the government – and therefore far easier to control.
“You want to keep your health coverage? You better vote for us!” will be the refrain every election year.
Moreover, Medicaid expansion would serve to steepen the “welfare cliff” confronted by many low-income households. This is an effect whereby – on the margins – people face losing valuable government benefits if they choose additional or higher-paying work. Accepting more work or a better job would actually make them worse off. “You better stay poor or you’ll lose your health coverage!”
The cycle of dependency, and thus political control, deepens.
“But Medicaid expansion would draw down billions in federal dollars, and those dollars will create tens of thousands of jobs,” insist Medicaid expansion supporters.
This sentiment, however, is based on faulty assumptions. As explained last year in this Civitas Institute article:
The job growth claims are based on the state’s “drawing down” additional federal funds due to Medicaid expansion … This income received by health care providers is then spent on suppliers (such as medicine, medical supplies, etc.) and in their community on goods and services such as groceries, clothes and movies.
The fatal flaw in this methodology, however, is that in order to “draw down” federal Medicaid dollars, actual medical services need to be provided to Medicaid patients. It is only when doctors actually treat Medicaid patients that the federal government pays those providers for the services.
One problem, however, is that Medicaid is already stretched thin, with too many patients chasing too few doctors. North Carolina’s Medicaid program has added a whopping 800,000 additional patients in the last dozen years – at a time when the number of Medicaid providers has decreased. Expansion would add as many as half a million more patients by some estimates. How does a shrinking pool of doctors provide care for 1.3 million additional patients?
With newly eligible Medicaid patients unable to see doctors, services won’t be provided and when no service is provided, no federal funds are “drawn down.” The assumptions backing up the job growth claims don’t reflect the very real supply constraints in the Medicaid program.
Dependency breeds control. The political class knows this. “To control the people, first make them dependent upon you.”
Medicaid, like so many other government programs, fosters greater government dependency, which makes citizens – especially low-income citizens – far easier to control. Which is just how the political class likes it.
For these reasons, House Bill 1073 is this week’s Bad Bill of the Week.