Obamacare Success: More Medicaid Enrollees; Less Medicaid

The government has arranged more Medicaid recruitment with less Medicaid reimbursement. What could go wrong?


Only a zealous statist (i.e. worshiper of the state) would be so blind as to not see what was going to happen. I’m sure there are many who did see it, like Jonathan Gruber, but who are laughing to themselves about the stupid American voters.

Sadly, the term “zealous statist” applies to all the major media networks, all democrats, many Republicans, and 99.9 percent of politicians of either party.

So we are all marching into a ditch just like Jesus warned us.

As you may know—perhaps because you or a loved one was signed up for it against your will when trying to purchase insurance through healthcare.gov—Obamacare has jacked up the number of people enrolled in Medicaid. But I think fewer people realize that the bureaucrats who lord over us are about to cut back on Medicaid reimbursements.

What do you think will happen?

[See also, “The Difference between Paul Krugman and Chuck Schumer on Obamacare.”]

Even the New York Times is willing to halfway admit the truth: “As Medicaid Rolls Swell, Cuts in Payments to Doctors Threaten Access to Care.”

Just as millions of people are gaining insurance through Medicaid, the program is poised to make deep cuts in payments to many doctors, prompting some physicians and consumer advocates to warn that the reductions could make it more difficult for Medicaid patients to obtain care.

The Affordable Care Act provided a big increase in Medicaid payments for primary care in 2013 and 2014. But the increase expires on Thursday — just weeks after the Obama administration told the Supreme Court that doctors and other providers had no legal right to challenge the adequacy of payments they received from Medicaid.

The impact will vary by state, but a study by the Urban Institute, a nonpartisan research organization, estimates that doctors who have been receiving the enhanced payments will see their fees for primary care cut by 43 percent, on average.

Stephen Zuckerman, a health economist at the Urban Institute and co-author of the report, said Medicaid payments for primary care services could drop by 50 percent or more in California, Florida, New York and Pennsylvania, among other states.

In his budget request in March, President Obama proposed a one-year extension of the higher Medicaid payments. Several Democratic members of Congress backed the idea, but the proposals languished, and such legislation would appear to face long odds in the new Congress, with Republicans controlling both houses.

Dr. David A. Fleming, the president of the American College of Physicians, which represents specialists in internal medicine, said some patients would have less access to care after the cuts. It would make no sense to reduce Medicaid payments “at a time when the population enrolled in Medicaid is surging,” he said.

Dr. George J. Petruncio, a family physician in Turnersville, N.J., described the cuts as a “bait and switch” move. “The government attempted to entice physicians into Medicaid with higher rates, then lowers reimbursement once the doctors are involved,” he said.

When I first heard of Obamacare, I thought it was obviously a deliberate attempt to implode the medical system as a strategy to push through socialized medicine. Then, later, with the insane problems that developed, I decided that no one would have wanted the implosion to happen that fast. It was too obvious that it was Obamacare that was the reason for the failure. So I attributed the failures to incompetence.

But this is different. It was so completely predictable. Despite my thoughts about blindness caused by state-olatry, I think this has to be a planned demolition. Surging Medicaid enrollment while planning all along to massively gut reimbursements is not a mistake; it is a plan.

And it doesn’t matter whether or not the Supreme Court thinks doctors have a “right” to challenge the adequacy of payments. Doctors only exist because people volunteer to become doctors. They have already begun retiring early. Soon, qualified students are not going to be motivated to invest the money and time in medical school. We are going to see the supply of healthcare dwindle–a government-produced benefit.