Greg Sargent of the Washington Post backs what I said last week: expanding Medicaid under the Affordable Care Act could save South Dakota money:
Republican governors who are threatening to opt out of the Medicaid expansion — which could deprive millions of insurance — have justified it by claiming that opting in could crush their state budgets. Their real motive may be ideological — they are striking a blow against Obama's signature initiative and the welfare state in general — but the cost argument gives them a seemingly pragmatic rationale.
...But... the Medicaid expansion could save money for states in other areas, the Urban Institute study concluded. First, the expansion could mean significant numbers of mental health patients now covered will soon be covered almost entirely by federal Medicaid funds. Second, the expansion could move many patients out of categories where states are currently paying a large matching share of Medicaid costs — such as pregnant women or people receiving long term home care — into Medicaid coverage that's almost entirely paid for by the feds.
And third, the Affordable Care Act overall — partly because of the Medicaid expansion, and partly because of subsidies and exchanges — will cut down the number of uninsured in ways that could significantly reduce "uncompensated care" — i.e., care that patients don't pay for, such as emergency services — thus reducing the amount of money states pay to hospitals to reimburse such care [Greg Sargent, "GOP Governors May Be Shafting Their Own States and Constituents," WashingtonPost: The Plum Line, 2012.07.05].
Sargent cites this July 2011 analysis from the Urban Institute. Naturally, he doesn't cite the South Dakota numbers... but I will:
- From 2014 to 2019, South Dakota would spend $112 million on the ACA Medicaid expansion (Dennis, pay attention! That's higher than the $99 million you're citing!).
- For that investment, we'd also get $1.79 billion more in federal dollars to keep our low-income folks healthy.
- As I said last week, the ACA reduces uncompensated care, saving the state of South Dakota between $97 million and $194 million.
- Looking at just those costs and benefits, the low-savings estimate says South Dakota may spend $15 million over six years to expand Medicaid. We could pay for that with just this year's better-than-expected tax revenue, a couple of bake sales at Denny's house, and Dusty Johnson doing a charity striptease over at the Hop Scotch. Or we could just use the future savings from rejecting Referred Law 16.
- The high-savings estimate says that, expanding Medicaid, South Dakota saves $82 million.
I don't have to be a bleeding-heart liberal to make this case: expanding Medicaid under the Affordable Care Act is an investment with a darn good chance of saving us money.
Where is the new federal funding coming from? The President's budget lists dramatic cuts to Medicaid for 2013 and beyond.
Someone was saying...wish I could remember who...that if the Governor's rejects the ACA money that it just pushes higher costs on the counties?
Anyone know how that would work?
Michael, send me a link on that budget, let's study.
Jana, maybe this is how that works: state rejects ACA Medicaid expansion, more people remain uninsured, more of those poor folks skip treatment until they are in more desperate straits, and they then turn to the county for indigent assistance on their medical bills.
But not to worry: Lake County will cover all those costs with its thrift store. Nothing like running a society on a perpetual rummage sale.
Exactly, Cory.
Matt Yglesias speculates that Plains states will be most likely to reject Medicaid money.
"That's why even though in the short-term I think the politics of Medicaid expansion will be driven by idiosyncratic features of whomever happens to be governor today, the longer-term issue looks different. States with plenty of health care providers will be hungry for the federal dollars, but states (primarily on the Plains) that already spend a great deal of time worrying that they don't have enough medical personnel will have a more serious long-term concern."
http://www.slate.com/blogs/moneybox/2012/07/05/does_uncompensated_care_raise_prices_for_the_insured_.html
Careful Cory. Don't let the facts get in the way of a lot of BS
http://www.ltlmagazine.com/news-item/obama-s-proposed-budget-calls-medicaremedicaid-cuts
The proposed budget, scheduled for release next week, features up to $3 trillion in deficit reductions over 10 years, according to a report in The Wall Street Journal. It also includes proposals to cut approximately $248 billion on Medicare and $72 billion on Medicaid and lower payments to nursing homes, reports The Wall Street Journal.
Cory, paying for your healthcare on the backs of your children is not saving anything...it is greed.
Paying for the so-called 'war on drugs' kills thousands of non-whites every two months, Steve: must be okay with you, huh?
Pfizer, Monsanto, and Syngenta are killing your relatives, Steve. OK because it's their right as corporations?
The SDGOP has paid these corporations to destroy groundwater supplies, Steve: who pays?
These corporations colluded with legislators to give your dad cancer, Steve.
and my dad, too.
Steve, you should try making that same argument with all the universal healthcare European countries who pay much, much less for healthcare, overall, than we do, every year.
Many counties spend significant portion of their budget on indigent health care costs. As it is now, simply being indigent does not qualify one for Medicaid in SD. As I understand it, with the Medicaid expansion of the ACA most or all of the low or no income people would be covered.
Steve, look at CEOs of insurance companies making a (cough) killing by tactics like dropping sick people and denying procedures to treat them. Is that kind of "greed" good?
Wanting affordable health care so that you can keep your house if you get sick, so that your child with a pre existing health condition isn't rejected and lumped with the who should "just die already". I find the hypocrisy of those who consider themselves "pro life", yet have nooooooo problem allowing those now born fight unjust wars for them, or think it is peachy to let a CEO make obscene profits by denying those trying to do the responsible thing.
US ranks 78th in the world for women participation in legislatures: @msnbctv's Melissa Harris-Perry.