By: Jason Lewis
The Pioneer Press
Before the Affordable Care Act was passed, Minnesota had one of the oldest, largest and more successful high-risk insurance pools in the U.S. This covered those who couldn’t get coverage in the individual market, but who also didn’t qualify for the federal-state Medicaid program designed for the disabled, poor children, the aged, and the blind.
In 2010, the Minnesota Comprehensive Health Association (MCHA) covered about 15 percent of all high-risk pool enrollees in the nation, and, in addition to assessments on insurers, state general fund appropriations financed assistance for low-income recipients. Premiums were roughly half of what they are today in the individual market.
Obamacare changed all that.
State-run high-risk pools were abandoned for one-size-fits-all federally mandated exchanges (such as MNsure) and a massively expanded Medicaid program. Except for the most partisan of observers, we all know how things turned out.
Premiums have risen 103 percent just since 2013, according to a new report from the Department of Health and Human Services. Forty percent of the nation is left with only one insurer. Aetna & Humana have already pulled out of the exchanges completely while Wellmark threatens to abandon Iowa — leaving nearly the entire state without an insurer in the individual market. Here at home, Minnesota’s $312 million state bailout of MNsure won’t come close to saving the 100,000 who’ve already had their plans cancelled.
Meanwhile, Medicaid spending has exploded — especially in Minnesota. When Obamacare offered to pay states a whopping 90 percent of the costs for expanding Medicaid to able-bodied adults without children — even though the federal match for the most vulnerable of current enrollees remained at 50 percent — we saw Gov. Mark Dayton and his fellow big spenders jump at the chance.
The result: 20 percent of Minnesota’s 1 million-plus Medicaid population is now made up of childless, able-bodied adults. That, of course, is one reason why Minnesota spends $11 billion on Medicaid while neighboring Wisconsin — with more people — spends $8 billion, according to the Kaiser Family Foundation.
It is this sort of fiscal irresponsibility that threatens the solvency of the combined $500 billion Medicaid program — not to mention those who truly depend on it. The perverse incentives of Obamacare’s Medicaid expansion have flooded the system with more people than it can handle.
Medicaid is our fastest-growing entitlement, and now covers the medical services of nearly 75 million Americans, including half of all births in the U.S. Moreover, 41 percent of non-disabled adults on the program don’t have jobs, due in part to a lack of work requirements for the able-bodied.
Meanwhile, disabled minors like 10-year-old Skylar Overman of Arkansas — born with a rare neurological condition — find themselves ranking at number 754 on the wait list for home health waivers because Obamacare sent more money to support able-bodied adults than to help children like Skylar.
There is hope on the horizon, however. Contrary to an orchestrated misinformation campaign from some on the left, the plans I am discussing in Congress are not that much different than the Clinton-era welfare reforms. In fact, President Clinton himself first proposed reasonable per-capita Medicaid spending limits all the way back in the ’90s — when the program was one-third of its current size.
More than two-thirds of the federal budget (including skyrocketing interest payments) is “mandatory” spending, like Medicaid. It is set to inflate to more than four-fifths of total spending by 2040 and is the principal source of the growing national debt, which now stands at $19.9 trillion — larger than the size of the entire economy.
No doubt, the most zealous ideologues will continue to push for larger cost-sharing subsidies for the bankrupt Obamacare exchanges, or a federally controlled single-payer system. But after such an epic failure of the current government-run healthcare experiment, most Americans (and Brits with record wait times at National Health Service) understand they can’t afford the “full monty.”
They want real reform; with falling premiums for the young and healthy and entitlement reform that actually saves programs like Medicaid for those vulnerable segments it was intended to serve.
They do not want an expanded welfare state the country can’t possibly afford.