Some of the most prudent arguments against Medicaid expansion are the detriments it will cause to state budgets. Last month I posted comments made by U.S. Rep Gary Palmer (R-AL) about how Medicare expansion “will swamp” the budgets of state’s going forward, leaving less and less room for other areas of mandatory spending. Thirteen states have balked at expansion since it became an option under the Affordable Care Act, more popularly known as Obamacare.
Obamacare enticed states to sign up for expansion by promising a 90 percent match of funds for the program in perpetuity. Admittedly, it’s an alluring deal and it had to be to push states to buy into a lackluster and costly program. Brian Balfour has already covered in-depth the ways in which Medicaid expansion would further crowd out private insurance on top of all the negative health outcomes.
Obviously, there are a lot of detrimental traps and pitfalls to expansion. However, I still think one of the strongest moral arguments against expansion is the overall unsustainability of entitlement spending at the federal level. Our own government is telling us that Medicare will be insolvent by 2026 and Social Security by 2035. Furthermore, Medicaid expansion completely threatens the viability of the program. I wrote an op-ed published in the Raleigh News & Observer on the insanity of our current federal spending related to Medicaid expansion and the desperate need for restraints to spending and entitlement reform. Unfortunately, all the warnings are not even being heeded by our federal lawmakers.
Expanding Medicaid without serious movement towards entitlement reform is grossly irresponsible. What needs to be done is a plan of block grants that better controls federal costs and gives greater flexibility for states to better address the health needs of the needier population.
North Carolina should be leading the discussion on pushing for federal reforms and fiscal sanity, not merely expanding dependency and cheerleading for unsustainable programs that are bankrupting the nation. It will take a serious commitment to place the proper restraints on government and relearn the purpose of government, but that is absolutely necessary to restore sanity on spending and promote the common good for all.