Medicaid expansion helps

People get better care; cost shifting will be reduced

Sen. Charles Scott

State Sen. Charles Scott, R-SD30, Casper, continues his relentless attacks on the Affordable Care Act and especially the expansion of Medicaid to cover thousands of Wyoming citizens who have no health insurance. The Equality State Policy Center disagrees with the senator’s assessment that the ” … the Medicaid expansion and its subsidies through the insurance exchanges … makes the health cost problems worse.” We do agree with his assertions in a recent letter to the Casper Star-Tribune that there are no free lunches. Here’s our response to Sen. Scott’s letter: Dear Editor: Sen. Charles Scott is right – there is no such thing as a free lunch or a free health benefit. However, his recent letter (Sunday, July 15) talked about increasing health care costs as though they are in the future, tied to the Affordable Care Act upheld by the U.S. Supreme Court. The reality is that every insured and self-pay patient already pays a “hidden tax” – higher insurance premiums and higher rates for services to cover the costs of providing health care for the uninsured. We tell the uninsured to get their health care in the emergency room, which is the most inefficient and expensive way to provide non-emergency care. Not to mention the financial folly of saving someone at death’s door only to turn the person back onto the street with no medicines or follow-up care. The combination of these two elements creates a death spiral of higher costs and poorer care. The Affordable Care Act aims at breaking the spiral by requiring everyone to pay for the privilege of having the emergency room standing ready to receive them, and to provide coverage for the poorest Americans so that the medical providers who care for them can get paid without resorting to cost-shifting. We commend Governor Mead for taking time to encourage discussion of whether Wyoming should follow the path laid out to cover the uninsured by expanding Medicaid with federal funds. Medicaid currently provides care for tens of thousands of Wyoming’s oldest and youngest residents. While it is easy to rail about the costs, we need to think about where the money spent ends up: in our state’s hospitals, doctor’s offices, pharmacies, nursing homes, and other health-related enterprises. We always should seek cost efficiencies, but trying to saving money by leaving people out of the system or arbitrarily limiting their care just makes the problem worse. The Medicaid expansion is a way to use our dollars to help our citizens. Rejecting the expansion just means the dollars we pay in federal income tax will be used to subsidize care in other states. Dan Neal Equality State Policy Center

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