Once Beshear starts down the road of Medicaid expansion, there’s no turning back

One excuse apologists offer for Gov. Beshear’s further adoption of Obamacare through Medicaid expansion is that states can abandon the bloated program in three years once the feds put the financial burden back on state governments.Balloon-Medicaid-4_jpg_800x1000_q100

Let’s get real, shall we?

Does anybody in their right minds even entertain the notion that professional politicians are going to pull the rug out from under more than 300,000 lower-income individuals who will soon be added to the Medicaid doles? If voicing the simple, commonsense notion to make even modest reforms to entitlement programs is considered political suicide, then removing entitlements from over 300,000 Kentuckians  must be the political equivalent of detonating a nuclear bomb.

What’s worse, the type of bold leadership in line with free market principles that would be necessary to shrink Medicaid to reasonable levels is simply not present in Frankfort. No professional politician is going to remove 300,000 people from an entitlement program unless he or she is preparing for a permanent retirement for politics.

Even if we want to venture through fantasy land and pretend that Gov. Beshear or his successor would have the intestinal fortitude to make such a bold move, it’s unclear that it would even legally be permitted to do so. According to legal experts, Robert Alt and Dan Greenberg:

“[I]n fact, there is substantial reason to believe that when a state chooses Medicaid expansion, it is something like a decision to go down a one-way street” and that “legislators are mistaken to ignore the possibility that expansion cannot be abandoned as easily as it was entered.”
Indeed, Beshear has us going down a one-way street the wrong way.

Political illusions and cheap tricks: The wrong medicine for Kentucky’s Medicaid malady

BluegrassBeaconLogoMore than 324 years after architect Sir Christopher Wren constructed fake pillars at Windsor Town Hall near London to satisfy building inspectors, tourists remain fascinated with the good-for-nothing posts.

The story goes that in 1689, local inspectors warned that the town hall would crumble without additional support. Rather than fight City Hall, Wren, England’s greatest architect – who disagreed with the inspectors – fooled them by building four pillars that offered the illusion of more support but which did not even reach the ceiling.

Stunts deceiving observers by illusion are not, of course, relegated to 17th century building inspections. They can occur in outright wallet-crushing fashion today.

Take, for example, Kentucky’s Medicaid shanty.

Inspectors have carefully examined the leaning structure and determined that adding 300,000 new enrollees into the Obamacare program – which Gov. Steve Beshear announced he will do – would add an unbearable financial weight to a structure that’s already crumbling. [Read more...]

BIPPS weighs in on Medicaid expansion for WHAS


On the eve of Gov. Steve Beshear’s announcement about his intention to expand Medicaid in Kentucky, Bluegrass Institute president Jim Waters had the opportunity to chime in on the debate. In a story by Joe Arnold of WHAS:

Under the law, the federal government would pick up the full tab of the increase for three years, but after that, Kentucky would have to fund ten percent of the added cost.

“We’re going to make a broken program bigger, not better,” argued Jim Waters, President of the Bluegrass Institute, a free-market think tank.

Expanding medicaid would inflict a one size fits all approach to Kentucky’s unique health care needs, Waters continued, ultimately reducing access for the people for whom Medicaid was created.

“And that is the truly poor and the truly disabled.  They need the care.  We need to find other ways to provide the other people better care as well,” Waters contended.

What does this mean for Kentucky? Well, you can read about that here.

 

A message to Gov. Steve Beshear about expanding Kentucky’s Medicaid program: Don’t do it!

“Some studies have found patients on Medicaid have worse outcomes than similar patients who have no insurance at all. And then, of course, there is the question of whether the states should be expanding a program that already eats a quarter of the typical state budget at a time when states are strapped for cash. The promise of federal funding to pay for the expansion has proven too enticing for some states to turn down, but there’s no guarantee that federal funding will continue indefinitely.”–The Heritage Foundation

‘Medicaid managed care blues’

A recent article about Medicaid managed care in Kentucky features quotes and research by Bluegrass Institute scholar Dr. John Garen.

The article titled “Medicaid Managed Care Blues in the Bluegrass State” by Kenneth Artz is a great overview of the situation that Kentucky now faces. It is no secret that Kentucky’s Medicaid program faces significant challenges. The most notable problem is the fact that without serious reforms, the current program is simply not sustainable.

John Garen, an economics professor at the University of Kentucky and a Bluegrass Institute adjunct scholar, says that the state’s Medicaid program was unsustainable regardless of the shift to managed care.

“It’s not unlike Medicaid in other states,” said Garen. “Prices are increasing just as the numbers of eligible folks going onto the rolls are increasing. It’s been growing just a few percentage points every year, but it all adds up. With the ObamaCare mandate expected to force more companies to no longer offer employee health insurance, even more are expected to join Medicaid. This will further increase costs.

“All of this adds up to Medicaid expenditures increasing faster than economic growth,” Garen said.

Garen authored “An Unsustainable Path: The Past and Future of Kentucky Medicaid” which made numerous recommendations about how the stat’s Medicaid program could be turned around.

There’s no time to waste as this problem becomes more serious by the day!

Education Commissioner admits increase in health care benefits unsustainable

Kentucky Commissioner of Education Terry Holliday has some sobering comments about how increasing health care costs for state employees and retirees are unsustainable.

In his discussion of the ballooning costs, Holliday simply declares:

“The current path is not sustainable.”

Holliday candidly admits this is “well above my pay grade” to solve, but his department and the education system it supports clearly is feeling the brunt of the legislature’s continuing failure to address this mushrooming problem.

Video: Economist John Garen on Kentucky Medicaid spending

Last week, The Bluegrass Institute was fortunate enough to be able to co-host an event with the Mercatus Center which included several distinquished speakers.

University of Kentucky economist Dr. John Garen spoke about the rising costs associated with Kentucky’s medicaid policies. Garen is the author of An Unsustainable Path: The Past and Future of Kentucky  Medicaid Spending, a Bluegrass Institute report released in 2011.

You can view the presentation slides that accompany this video here.

An Unsustainable Path: The Past and Future of Kentucky Medicaid Spending

Kentucky Medicaid is on an unsustainable path. Its expansive spending growth over the past 25 years has put increased pressure on state and federal budgets. Medicaid has failed to fulfill the goal of improved health for most of its recipients. The recently passed Patient Protection and Affordable Care Act (PPACA) did not enact any fundamental reforms in Medicaid but expanded the program dramatically. Kentucky and the nation deserve much better regarding serving the taxpayers and in crafting a program that assists the truly needy. Read the full report here.

 

Video: ‘An Unsustainable Path’ author discusses Medicaid

Recently the Bluegrass Institute published “An Unsustainable Path: The Past and Future of Kentucky Medicaid Spending“. The video below is from the release of the report. Author John Garen provides an overview of his findings.

Medicaid/Medicare Fraud Reveals Incentive Problems

Following up on what Holly presented this morning, I’ve produced a short video with the Cato Institute’s Michael F. Cannon detailing some of the particularly nasty aspects of Medicaid/Medicare fraud.

One of the issues that makes Medicaid/Medicare fraud so intractable is that the lawmakers who approve the programs’ spending have muted incentives to crack down on fraud since any antifraud program would impose costs on constituents. If you haven’t yet, read John Garen’s report on Medicaid in Kentucky.