Rep. Brad Tschida

Rep. Brad Tschida, a Republican from Missoula, tells the House Appropriations committee in a Saturday hearing why he opposes the Medicaid program enacted in Montana in 2015.

As a part of the federal governments’ Affordable Care Act, Montana’s Medical Expansion program was designed in 2015 to provide access for lower income previously uninsured citizens to good healthcare coverage at affordable premium cost. All expectations far exceeded that, and were MedEx a potential stock purchase, it would have been a “strong buy call,” a “high-reward-low-risk investment with a high ROI.”

Often overlooked is the fact that all benefits of Montana’s MedEx program to date were achieved with nearly 100 percent federal government funding resulting in a huge savings for the stressed Montana taxpayer. Additionally, the federal government will pay 90 percent of the cost of the State’s MedEx program forever into the future, which is a huge reduction in Montanans’ long-term tax load.

Unfortunately, Montana’s MedEx sunsets in June and, if not renewed during this legislative session, the gains will be lost for our future.

Rep. Mary Cafferro introduced HR425 to make Montana’s MedEx permanent and it is strongly supported by citizens and both the medical and business communities.

Rep Ed Buttrey introduced Republicans’ version of MedEx, HB 658, but its program objectives, requirements and projected outcomes are very different than HB 425. The stated objective of HB425 is to make MedEx accessible to as many Montanans as possible, while HB 658’s objective is to get as many Montanans off MedEx. HB 658 appears more like a welfare bill than a healthcare bill, adding requirements to ensure patients “have skin in the game.” The goal is to cut more than 40 percent of those eligible for coverage from rolls to decrease the size of government. It should be obvious that adding bureaucratic red tape makes MedEx more costly to the taxpayer.

To justify their bill’s restrictive requirements, Republicans continue to falsely claim the federal government can’t afford to subsidize citizen health. Montana state Sen. David Howard at Saturday’s MedEx committee hearing evoked this myth by claiming the” federal government can’t continue to pay for programs under a growing national debt” and asks, “Do we love our government if we continue putting it further in debt? Do we love our state is we don’t keep it solvent?”

Howard’s statement is pure hogwash. The debt excuse is always dragged out whenever Republicans object to funding needed public services. It is a purely fabricated scare tactic widely used by “small government” ideologues to justify cutting government professional staff and privatizing public lands and services.

Small government ideology should never be used as an excuse for making bad legislative decisions. It’s time to debunk these common myths politicians have long used that have led to gross wage and wealth inequality on Main Street.

Here are the facts:

• The financial management of the federal government is very different from state governments.

• Money, except the physical paper and coin we carry in our pockets, is not created by “printing.” Money is created out of thin air by Congressional spending bills earmarking where the money is to be spent and deposited in appropriate accounts at the federal reserve.

• Deficit spending is the only source of new money to grow our economy. There is no money for us citizens to pay taxes with unless Congress first spends it into the economy.

• The so-called national debt is not a burden to our children; it is an asset to those children fortunate to own U.S. Treasuries (the “so-called national debt”).

• The U.S. government has never gone bankrupt, nor could it ever go bankrupt. That is a bogus worry created and perpetuated by neoliberal politicians.

• State governments, on the other hand, like businesses and households, must balance spending with revenue (taxes).

• No legislator should worry about the federal government being able to afford to subsidize MedEx program. The federal government can easily afford it and it is sustainable forever into the future.

It should be noted that no private insurance system operating under a for-profit business model can ever provide the kind of full coverage healthcare insurance needed that is affordable for a large fraction of the population unless the federal government subsidizes the premium cost.

In reality, it is the private insurances’ profit and administration costs the federal government is subsidizing to make citizens’ premium costs affordable.

Which begs the question: Shouldn’t we be requiring private insurance companies to “have the skin in the game, rather than the patient?”

Bottom line: Montanans don’t need free-market healthcare choices. We do need affordable coverage. Healthcare is not a free-market commodity and should never be treated as such.

Duane Catlett is an expert in political economy and the role of the federal government in sustaining a full employment economy. He is a retired scientist, university professor, and materials R&D technology manager who lives in Bozeman.

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