Rob Schofield at NC Policy Watch decided to commemorate Medicaid’s 55th anniversary with “some basic facts” about the program in his “Monday Numbers” column this week.
Many of the numbers were dedicated to the issue of Medicaid expansion, and as you might expect, several quite relevant numbers were left out.
As a public service, I’ve added some numbers about Medicaid expansion to paint the more complete picture that Schofield doesn’t want you to see.
1.3 million Increase in number of North Carolinians enrolled in Medicaid from 2003 to present
Up to 634,000 Number of additional people potentially enrolled in Medicaid if NC decided to expand
1,300 Decrease in doctors seeing Medicaid patients from 2003 to 2018
0 Times that Schofield acknowledges this crisis of access to care or attempts to explain who Medicaid enrollees will see when they get sick if more than half a million more people are stuffed into an already overcrowded system.
29 Percent Share of North Carolina doctors that said they either “limit” the number of Medicaid patients they see, or don’t see any at all.
2.5 More Visits A 2017 study published in the Annals of Emergency Medicine journal concluded that emergency room “use per 1,000 population increased by 2.5 visits more in Medicaid expansion states than in non-expansion states,” and that increases in such visits were largest for “states with the largest changes in Medicaid enrollment.” In short, expansion is associated with an increase in usage of the more expensive ER treatment, which helps drive up overall healthcare costs.
70% Share of ER doctors who “believe their emergency department is not adequately prepared for potentially substantial increases in patient volume,” according to a 2015 survey by the American College of Emergency Physicians.
0 Times that Schofield acknowledges the increased ER usage in Medicaid expansion states, which is not only evidence that Medicaid enrollees have trouble accessing a regular doctor but also drives up healthcare costs. Nevermind the fact that more than two-thirds of ER doctors believe they would be overwhelmed by the increase in usage.
$410 million The estimated cost to the state in the first year of Medicaid expansion alone. This cost, according to expansion advocates, would mostly be paid for by a new tax on hospitals.
0 Times that Schofield acknowledges this cost or attempts to explain the fiscal impact it would have on our healthcare system.
63 percent Estimated share of new Medicaid enrollees under expansion that would come from the ranks of private insurance.
$1.2 Billion Shortfall in NC between Medicaid reimbursements to hospitals and the costs of providing care to Medicaid patients in just one year because of low Medicaid reimbursement rates, according to a NC DHHS spreadsheet summarizing 2014 supplemental payments (the latest data available). Bottom line: hospitals lose money on nearly every Medicaid patient they treat.
0 Times Schofield acknowledges this or attempts to explain the financial consequences on hospitals if a significant share of their patients shifted from the higher reimbursements of private insurance to the low reimbursements of Medicaid.
40 percent Share of Medicaid expansion states that lost hospital jobs in the first year of the program. Indeed, the study also found “hospital job growth has actually been more rapid in states that rejected this failed welfare expansion.” This helps undercut MedEx supporters’ claim that expansion will somehow create jobs. If expansion doesn’t even boost hospital jobs, how are we to believe it boosts overall jobs?
$26.6 Trillion Size of the federal government’s debt – the same federal government that Schofield thinks we should rely on to finance most of Medicaid expansion.
0 Times Schofield acknowledges the national debt or attempts to explain where the billions in new funding for North Carolina Medicaid expansion would come from.