Demand real Medicaid reform

Jim Capretta explains clearly to any governor thinking about expanding Medicaid why this is a short-sighted, destructive idea.  His piece at National Review Online is entitled “End Medicaid’s Crony Federalism.  GOP governors should refuse the White House’s deals and fight for Medicaid reform.”

Capretta, a scholar at the Ethics and Public Policy Institute, says that the Obama administration is desperate to get states to comply with what the U.S. Supreme Court declared to be an optional expansion of Medicaid under ObamaCare to cover families earning up to $30,000 a year.

The law won’t come close to reaching “universal coverage” if the nation’s governors refuse to expand their Medicaid programs. Which is why these governors, and most especially the 30 Republicans among them, have substantial power and leverage to bend national health-care policy in their direction — if they play their strong hand correctly.

Unfortunately, many of the GOP governors are acting otherwise. Seven Republican governors — including Chris Christie, John Kasich, and Rick Scott — have announced their intention to essentially go along with the Medicaid expansion, and several others are thinking about following their lead.

…Not surprisingly, the White House and HHS secretary Kathleen Sebelius are doing all they can to pick off one GOP governor at a time. When Governor Kasich announced his support for the Medicaid expansion a month ago, he said he had been in touch with top White House aide Valerie Jarrett, who had assured him the administration would be open to making special concessions for Ohio. In Florida, Governor Scott’s announcement was accompanied by HHS’s approval of a broader Medicaid waiver program for the state that doesn’t fundamentally alter the nature of Obamacare’s government-centric approach to health-care reform. And news stories now indicate that Governor Tom Corbett of Pennsylvania is planning to meet with Sebelius within the month, no doubt to see what kind of special deal he can secure for his state.

The latest Medicaid frenzy involves a Democratic governor from a red state, Mike Beebe of Arkansas. There was no prospect of securing approval for a straight Medicaid expansion from the state’s Republican-dominated legislature, so Beebe came to Washington recently with what he expected to be a long-shot request: Would HHS allow Arkansas to use the federal money from the Medicaid expansion to purchase private insurance for those who would otherwise have qualified for Medicaid?

In another indication of how desperate the White House is to get red-state America to buy into Obamacare, HHS officials have told Beebe they are open to the idea. Predictably, now more Republicans are interested in getting the same “deal” as Arkansas, even though no one in HHS or Arkansas has yet fully explained what the deal would entail.

The bottom line:

Even though some GOP governors have already announced their Medicaid intentions, it is still not too late for the broader group to adjust their tactics and use effectively the leverage the Supreme Court handed to them. In criticizing Obamacare, Republicans often say that it makes no sense to add 15 million people to an unreformed and unstable Medicaid program. They are right, and they should take the opportunity that now presents itself to secure permanent, statutory reform of Medicaid, not special side deals.