Well, we apparently can’t rely on the mainstream media in Ohio to fact check the claims of Governor John Kasich and Lt. Governor Mary Taylor about Obamacare. So we will continue to do it.
We will fact check one claim: that the expansion of Medicaid will increase costs to Ohio.
After the Supreme Court’s ruling on the Affordable Care Act, Ohio (like every other state) has the option to participate in the expansion of Medicaid.
Kasich and Taylor have equivocated. Greg did some great reporting earlier on their inconsistencies – check it out. (One point to their credit: they haven’t said any Batshit Crazy stuff about Medicaid infringing on state sovereignty like Rick Perry.)
In the “Kasich Administration Paper of Record,” the Columbus Dispatch, Taylor claimed: that “the state will pay additional Medicaid costs even without expanding the program.” She told the paper “the state’s share of the additional coverage cost will be $369?million in 2014 and increase to roughly $675 million in 2018.”
The Plain Dealer quoted Taylor: “Quite frankly we’re not sure where we’re going to get the money from to cover the additional obligation of spending, let alone have the discussion about the expansion of Medicaid.”
Later, the Plain Dealer said that Kasich cited the costs as being a barrier to the Medicaid expansion. “Kasich’s administration says the cost is too much, in part, because Ohio already has to pick up the bill for more people expected to enroll in Medicaid once the law’s individual mandate, requiring most people to have health insurance, takes effect. Kasich estimates that could cost Ohio $940 million in 2014 and 2015.”
(The prize for unsubstantiated hyperbole has to go to State Rep. Jay Hottinger, R-Newark, who said: “It’s $3 billion a year — that’s a substantial amount of money. . . That’s $3 billion less to spend on schools and other functions of state government.” We have NO IDEA where he got THAT number!)
So . . . let’s fact check the claim that expanding Medicaid in accordance with the Affordable Care Act will cost Ohio a lot of money.
The starting point is that for the first three years, the federal government will providing 100 percent of the money to cover the Medicaid expansion. In 2020, the contribution will decline to 90 percent. Under current law, the federal government pays about 57 percent of Medicaid costs.
By adding to the current federal match on Medicaid spending, The Non-Partisan Congressional Budget Office estimated that the Affordable Care Act will result in a 2.8 percent increase in state Medicaid spending. However, and this is important, the report concluded that Medicaid expansion would not add to total state spending because expanding Medicaid expansion would reduce state and local government costs for uncompensated care and other services provided to the uninsured.
The Center on Budget and Policy Priorities just released a terrific analysis that reviews the CBO report. They conclude: “the Medicaid expansion will cover 17 million low-income people at a very modest cost to states — a cost that will be at least partly offset by savings in uncompensated care and other state-funded services for the uninsured.”
Some analyses, like this report from the Urban Institute, have concluded that the savings from no longer providing uncompensated care and other services for the uninsured will be greater than the costs of Medicaid expansion – in plain English, states will make money by expanding Medicaid.
The argument for increased costs is many people who are already eligible for Medicaid, but who have not enrolled for some reason, will join the program. The costs of insuring these people would be funded by the Federal government under the old, lower match. This sounds like what Taylor and Kasich are talking about; but their mistake is to isolate those costs. When the whole program is looked, the numbers don’t support this claim. The CBO and Urban Institute reports all include the cost to states of covering the already-eligible individuals who will enroll.
Conclusion: we give the claim by Kasich and Taylor that expanding Medicaid in accordance with the Affordable Care Act a “Four Pinocchio’s” rating or a “Pants on Fire” rating or whatever else those Mainstream Media Types use when they check facts.