Setting the record straight on Medicaid expansion in Alabama

Are you paying more or less for health insurance than you were 10 years ago?

It's an important question, and one that's on the minds of a lot of policymakers as we approach the 10-year anniversary of the implementation of Obamacare. For most Alabamians, the answer is undoubtedly that health care costs have gone way, way up.

Yet if you read Rob Holbert's recent "Damn the Torpedoes" about Alabama expanding Medicaid to able-bodied adults under Obamacare, you would think that doubling down on Obamacare is a no-brainer. More health coverage and hospitals, right? Well in the words of Lee Corso, "Not so fast."

Here's the truth: The conversation around Medicaid expansion in Alabama has been so muddied with misinformation that we need to take some time and set the record straight.

I want to focus on three numbers: 600,000, $100 million and $3.5 billion.

First, 600,000. That is the number of able-bodied adults that would be added to the welfare rolls if Alabama expanded Medicaid under Obamacare. If you read Mr. Holbert's editorial — which talked at length about individuals with disabilities, children, etc. — you would think they, too, would benefit from Medicaid expansion. Let me be clear: Only able-bodied adults would be impacted by Medicaid expansion. In fact, Mr. Holbert actually notes that 80 percent of potential expansion enrollees do not even have children. So what we are talking about is enrolling hundreds of thousands of childless, able-bodied adults — far from the most vulnerable in our state — at a time when1,000 Alabamians with developmental disabilities remain stuck on Medicaid waiting lists.

Second, $100 million. Medicaid expansion is often pitched as the cure-all for hospitals across the country. Mr. Holbert is outraged by how few hospitals there are in rural Alabama, and I hear his concerns. But Medicaid expansion would not be a silver bullet for these hospitals. Rather, it would be a nail in the coffin. If Alabama expanded Medicaid under Obamacare, it would realize approximately $100 million in hospital Medicaid shortfalls because Medicaid reimbursement rates to providers are so low. That is equal to about 2,250 lost hospital jobs. In every state that has expanded Medicaid, false claims of "saving hospitals" never come true. Just look to Arkansas, where hospitals shuttered their doors after expansion was implemented despite promises of hundreds of new hospital jobs. Today, the states with the fewest hospital beds per capita — Washington, New York, Maryland, etc. — are all Medicaid expansion states. Put simply, Medicaid expansion does not save hospitals — it buries them.

Finally, $3.5 billion. That is the cost of Medicaid expansion to Alabama taxpayers over the next decade. And despite what you may hear, every single state that has expanded Medicaid has seen both enrollment and costs shatter the predictions of so-called experts.

These are the cold, hard facts of Medicaid expansion.

Now, Mr. Holbert does get one point right: The cost of inaction is unacceptable. But the answer is not bigger government through massive expansions of welfare that would bankrupt taxpayers and hospitals alike. Instead, eliminating costly Certificate of Need (CON) laws that drive up the cost of health care; allowing non-profits to offer flexible health care options; expanding the scope of practice of our frontline nurses; and more are actions we need to be taking to make health care more affordable and accessible in Alabama.

What Alabama cannot afford is a doubling down on the failed promises of Obamacare by saddling taxpayers with what would be the largest expansion of welfare in the history of our state, which would not help a single child, senior or disabled individual.

Our policymakers need to resist the all-too-alluring urge of expanding Medicaid. Instead of buying into the gimmicks and false promises, let's focus on the facts and stand up against the harms of Obamacare.

Trip Pittman is a husband, father, small businessman and former member of the Alabama State Senate.