One of the most significant yet underreported outcomes of ObamaCare is its impact on the truly needy. Before ObamaCare, our country maintained a safety net that was reserved for our neediest neighbors. The Medicaid program, for example, primarily served poor children, seniors, and individuals with disabilities.
But ObamaCare’s Medicaid expansion sought to change this. It sought to transform a safety net into an open-ended, free-for-all welfare program for non-disabled, working-age adults, the overwhelming majority of whom have no dependent children at home. Every penny spent on this new population is a penny that can’t be spent on the truly vulnerable. That’s just a fact.
Many of these individuals – nearly 600,000 nationwide – currently sit on Medicaid waiting lists, hoping to get additional services that states say they need but, due to limited funding, states can’t afford. Literally, states have said, “You need this service but we do not have the adequate funding to provide it for you.” As a result, these individuals sit and wait. Many of them will die before they ever get the care they need.
Some might call that rationing. At best, it is misprioritization.
So I was alarmed when I read a Washington Post “fact check” that awarded “four Pinocchios” to statements which cited these facts. Even more unsettling, the Post failed to analyze the actual statements that were made. (No wonder just 29 percent of voters say they trust “fact checkers.”)
First, the Post attempted to fact check the claim that ObamaCare’s Medicaid expansion created the Medicaid waiting lists.
Fact: No one made this claim.
Instead, the waiting list was provided as evidence that our truly needy neighbors are already being underserved by the Medicaid program. The point – with which an overwhelming majority of Americans agree – was that services for seniors and individuals with disabilities should be a higher priority than welfare for able-bodied, childless, working-age adults.
The Post also tried to fact check the claim that ObamaCare’s Medicaid expansion increased waiting list enrollment.
Fact: while no one made this claim, there’s far more to the story than the Post explains.
The Post cites selectively-trimmed waiting list data from Illinois and a report from a leftist “think tank,” saying the state’s waiting list has “actually decreased” since 2013.
Conveniently, they never explain why this reduction occurred, leaving the impression that those removed from the waiting list are now receiving the services they need.
Since Illinois opted to expand ObamaCare, just 29 percent of the individuals removed from Illinois’ waiting list received all the services the state says they need. The rest of the reduction was due to death, moving out of state, or other reasons.
The Post apparently sees these truly tragic facts – the underserving of the truly needy, including the death of nearly 800 Illinois waiting list members– as a positive development.
Furthermore, while no one claimed the waiting lists have increased because of ObamaCare, it is certainly possible that this could happen in the future – especially now that states are paying a larger share of expansion costs.
ObamaCare expansion’s perverse funding formula directly threatens the truly needy who are served by traditional Medicaid, including those receiving community-based services. This funding formula currently gives states 95 cents on the dollar for ObamaCare’s able-bodied adults. But for traditional Medicaid enrollees, states receive just 55 cents on average.
Going forward, states will be able to save more money by cutting from the traditional Medicaid program rather than from their expansions, placing the truly needy at direct risk. Some states have already put these cuts on the table.
Finally, the Post never answered the initially-posed, real question – whether or not ObamaCare’s Medicaid expansion to non-disabled adults came at the “expense” of those on the waiting list.
Fact: The only correct answer to this question is “absolutely.”
To reiterate, every penny spent on ObamaCare’s expansion is a penny that cannot go to help the truly needy. Unless the same penny can be spent twice – and it should be clear that it cannot – these are funds that could go to help the truly needy. Instead, they have been redirected to fund a new welfare program for able-bodied adults.
Skylar Overman is one of nearly 3,000 individuals languishing on a waiting list in Arkansas. Her rare neurological condition requires her to take dozens of medications a day and eat through a tube, unable to walk or talk. Just 11 years old, Skylar has already spent a decade waiting for the services she desperately needs. If anyone is deserving of help from our safety net, it’s Skylar.
And yet, while Arkansas signs up as many able-bodied adults as they can for its ObamaCare Medicaid expansion, Skylar has been forced to wait. This demonstrates a fundamental flaw in the prioritization of limited taxpayer resources, which is exactly the problem.
This article originally appeared on The Hill on April 1, 2017.