Guest opinion: Medicaid expansion no freebie for taxpayers

2013-03-11T00:05:00Z Guest opinion: Medicaid expansion no freebie for taxpayersBy JEFF ESSMANN The Billings Gazette
March 11, 2013 12:05 am  • 

The promise of getting something for nothing has been charmingly tendered by a variety of elixir salesmen for centuries. That same bait is now being touted by the Obama administration, Gov. Steve Bullock and the powerful hospital lobby who are now pushing to expand Medicaid to cover an additional 70,000 Montanans while the administration can’t even provide accurate numbers about how many are currently covered by Medicaid or at what cost.

Former Gov. Brian Schweitzer accurately called Medicaid a program that would “run the risk of bankrupting Montana.”

Medicaid fraud

You can confirm the abuse, fraud, and dysfunction of Medicaid by asking a front-line worker in the health care industry for their private opinion, but don’t let their bosses hear about it. They want more money to pour into the broken system now, while offering the possibility for reform later.

What the state of Montana needs is reform first and a real examination of the pressure that expanding the program will place on the taxpayers on Montana. Instead of waiting until the midpoint of our legislative session to learn details of the Medicaid expansion proposal, which is what we face now, we need the opportunity to have a serious discussion about the expansion. That way we can answer this question: Does the benefit exceed the cost?

The Child and Family Services Interim Committee of the Legislature attempted to engage the major stakeholders, i.e. the state agency operating Medicaid and the hospital providers that benefit from the payments, on how to go about reform. Unfortunately, these stakeholders offered exactly 11 minutes of testimony over 20 months on the question of reform, leading us to question the sincerity of their promises to enact reforms in the future.

With the current debt of $16.8 trillion weighing on the federal budget and the first, but not the last, federal budget cuts arriving in the form of the March 1 sequester, now is not the time to expand our reliance on the federal government. Do we really want to condemn our children and grandchildren to the lower quality of life they will inevitably inherit along with ever-increasing tax burdens to pay off the credit card balance this generation is racking up as if there was no tomorrow?

Medicaid expansion might be a quick economic shot in the arm to our powerful medical providers, but it will come at a major cost to the small-business employers and employees of Senate District 28 that I represent. These constituents are the people struggling to pay ever higher medical bills and premiums while the hospitals continue to build their medical edifices with revenue,  66 percent of which already comes from government sources. Now they are seeking even more as if the people of Billings don’t have to pay federal taxes, state income taxes, or property taxes.

Hospital lobbyists

In the era of Copper Kings 100 years ago, the Montana press and Legislature was under the choke hold of the “copper collar.” With over 50 lobbyists roaming the halls of the Capitol in search of votes for Medicaid expansion, one wonders whether the copper collar has been replaced with the hospital collar. And when the federal money diminishes, will future legislatures be under intense pressure to raise income taxes and property taxes, which these hospitals don’t pay, in order to pay yet again for this so-called economic expansion? Yes, they will.

That is why Medicaid expansion is not a freebie and it’s not an elixir. Montana would be wise to check the fine print so we don’t end up handing the taxpayers foot the bill for a lemon.

Jeff Essmann, R-Billings, is president of the Montana Senate.

 

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