The government shutdown and the downgrading of the nation’s creditworthiness over the debt-ceiling was the previous high water mark for GOP cynicism. But now the GOP has outdone themselves – the toll for their refusal to expand Medicaid in 24 states might as well be measured not in dollars, but in corpses.

A new study out of Harvard Medical School estimates that between 7,000 and 17,000 people will die as a result of states’ refusal to expand Medicaid. And how much money will those states save, to justify that loss of life? Nothing at all! Zero, zippo, nada. As a kicker, businesses within those states will be subject to fines of $2,000 per uninsured – and workers within those states will still pay the same federal taxes to benefit the residents of the 26 other states who opted into expanded Medicaid. To score political points, the GOP is today killing poor working people – while local business pays for the fun. Expanded Medicaid is already paid for – state officials just have to sign on the dotted line to start receiving benefits – but conservatives would rather pay the bill and refuse the benefit, ensuring that thousands of poor people will needlessly die.

People with incomes between 100% and 138% of the federal poverty line do NOT qualify for federal subsidies to purchase private insurance. (Subsidies only go to people between 138% and 400% of the poverty line.) Their solution was Medicaid expansion. When the Supreme Court rewrote the law to let states opt out, those people were given no alternative – they were categorically shut out of the system. Plan B for the working poor is Dont get sick. Many of them now will not get screened for breast or cervical cancer; many diabetics will have to do without medicine; many others will be at greater risk of depression; many will be bankrupted by catastrophic medical expenses. And many will die – needlessly.

This study is not alone. More modest studies scrutinizing individual states tell a similar story. When a state opts out of Medicaid expansion, people die, businesses get hit with penalties, and Federal taxes effectively siphon money out of the state – paying for a benefit that they obtusely refuse to receive!

Still more studies are already documenting how opting out adversely affects the numbered of uninsured. Opt-out states have seen rates of uninsured drop by just 1.5% since September – while opt-in states have seen that rate fall by 4%. As of March, the rate of uninsured for opt-in states was 12.4% – while for opt-out states it was 18.1%.

Medicaid expansion is a sweetheart deal for states. For the first 3 years of the program, states pay nothing at all. Their share gradually increases thereafter, but will never exceed 10%. And since expansion is likely to offset other state expenditures, states’ effective share of the program is likely to be even less than 10% over the long haul. Adding perversity to perversity, conservative refusal to expand Medicaid serves to regressively redistribute wealth out of poor (GOP) states and into rich (DNC) states – yet another opportunity for the GOP to sock it to their own constituents for a hollow ideological purpose.

 

Refs:

http://healthaffairs.org/blog/2014/01/30/opting-out-of-medicaid-expansion-the-health-and-financial-impacts/

http://www.cbpp.org/cms/?fa=view&id=3801

http://pnhp.org/blog/2014/01/30/state-medicaid-opt-out-will-cost-over-7000-lives-maybe-17000/

http://orlandoweekly.com/news/the-perils-of-florida-s-refusal-to-expand-medicaid-1.1665144?pgno=2

http://www.wral.com/new-studies-medicaid-opt-out-costly-for-nc/13349683/

http://www.cbsnews.com/news/obamacares-impact-differences-emerge-between-states/

http://www.thenation.com/blog/168634/supreme-court-upholds-mandate-mixed-ruling-medicaid-expansion