We held an open caucus meeting during Interim Session this month to discuss some new information regarding Utah's experience with the Affordable Care Act. One of the most revealing topics of conversation had to do with criticism the House has received for its stubbornness in not moving forward with the Governor's Medicaid Expansion plan as proposed.
One of the first arguments that is made by supporters of the plan and the media is that Utah is being penny wise and pound foolish by not expanding Medicaid. Their argument for the past two years has been that with the Federal Government "committing" to pay 90% of the costs of the program, we are losing out on tax money we are already paying to the Feds. They say we have been paying taxes and not getting anything back to show for it. Here are a few snippets from emails I received from supporters of Medicaid Expansion:
"By not expanding medicaid Utah can't access the healthcare the Utah taxpayers have already paid for during the last 2 years."
- Ms. Summers
" MR PETERSON, I'm not at all happy how you and the others voted on the Medicaid Expansion!! We elected you for the views of the people you represent, NOT on your views!! I do not need Medicaid but so many others do! You should all be ashamed of yourselves! Then you leave ALL that tax payer's money on the table!!"
- Ms. Phelps (emphasis added)
Surely, the public believes that there is a steep price to be paid to avoid entangling ourselves in an uncertain deal with the Federal Government. Supposedly, to reject expansion is to forfeit hundreds of millions of our tax dollars and consign us to watching our poor and disadvantaged die en mass. At least that is what advocates want you to believe. This inaccurate narrative has been pushed by the big-hearted but grossly misguided folks at the Utah Health Policy Project and Alliance for a Better Utah among others.
This tax dollar narrative has been particularly effective in provoking public sentiment. Yet, it is an outright lie. How so? Here are the facts;
As you can see, Utahns are paying $710 Million a year in taxes collected by the Federal Government related to the Affordable Care Act. That is a lot of money. However, contrary to the convenient narrative pushed by advocates for Medicaid Expansion, Utah is receiving $730 Million a year from the Federal Government to pay for subsidies, cost-sharing, CHIP and other coverage programs.
The truth is we actually receive MORE than we pay in tax dolloars! Whoa!
So, the next logical question is about how would Medicaid Expansion affect these dollars. Would we get more? Of course! But where would they come from? They would come from other states who had the ignominious distinction of having to pay more than they receive. Ironically, expanding Medicaid in Utah would put other states in the same situation that advocates are falsely claiming we are in today. Regrettably, beggar-thy-neighbor appears to be in vogue.
Bad data makes for bad policy. Lets stop the charade of telling taxpayers they are wasting their money if they don't submit to a massive entitlement expansion. It simply isn't true.
Meanwhile, we will be seeking other more sustainable solutions to help the truly disadvantaged in our state.
One idea would be to identify specific groups of people that are truly in need and design a system for helping them. Some suggestions include the profoundly mentally ill, the institutionalized disabled, those transitioning from incarceration to society, and those who are temporarily unable to work due to treatable illness or injury. Let's put our heads together to find ways to create targeted assistance that meets needs in a compassionate, sustainable way.
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