Sunday, June 9, 2013

Paul Krugman: Republicans Reject Medicaid Expansion Out Of Spite

Why are a number of Republican-led states opting out of a federally financed expansion of Medicaid? It's a given that the GOP doesn't care about the poor; this action, however, hurts state budgets and will hurt the party politically. Paul Krugman explains that the Republicans are acting out of sheer spite against the most vulnerable:

A new study from the RAND Corporation, a nonpartisan research institution, examines the consequences if 14 states whose governors have declared their opposition to Medicaid expansion do, in fact, reject the expansion. The result, the study concluded, would be a huge financial hit: the rejectionist states would lose more than $8 billion a year in federal aid, and would also find themselves on the hook for roughly $1 billion more to cover the losses hospitals incur when treating the uninsured.

Meanwhile, Medicaid rejectionism will deny health coverage to roughly 3.6 million Americans, with essentially all of the victims living near or below the poverty line. And since past experience shows that Medicaid expansion is associated with significant declines in mortality, this would mean a lot of avoidable deaths: about 19,000 a year, the study estimated.

Just think about this for a minute. It’s one thing when politicians refuse to spend money helping the poor and vulnerable; that’s just business as usual. But here we have a case in which politicians are, in effect, spending large sums, in the form of rejected aid, not to help the poor but to hurt them.

...rejectionism won’t discredit health reform. What it might do, however, is drive home to lower-income voters — many of them nonwhite — just how little the G.O.P. cares about their well-being, and reinforce the already strong Democratic advantage among Latinos, in particular.

Rationally, in other words, Republicans should accept defeat on health care, at least for now, and move on. Instead, however, their spitefulness appears to override all other considerations. And millions of Americans will pay the price.


Michael The Molar Maven said...

In reality, expansion of Medicaid serves to distribute the costs of treatment far more equitably. As the system stands right now, medical care at hosptials is not refused to anyone who needs emergency, life-sustaining treatment, regardless of ability to pay. In other words, the cost of treating the uninsured is born almost totally by those who have coverage (or those who can pay their bills without insurance) only, via surcharges and higher fees. Covering a larger portion of the population will divide the costs more evenly among all taxpayers. There is no downside to expanding medical insurance to all who reside in the United States. It is the only moral course of action...and it makes financial sense as well.

Jeff Tone said...

Absolutely--but we're speaking of Republicans whose actions have neither a moral nor fiscally sound basis. They're motivated by pure spite, as Krugman asserts.