Medicaid opinions: Several state leaders come in for heat for not moving toward expansion

Editorials and columnists in several papers around the country pressed officials toward accepting a Medicaid expansion and offered suggestions about implementation. Also, comments continued about a recent study on Medicaid.

Los Angeles Times: A Public Health Compromise For California
The Legislature is poised to offer health insurance to millions of additional low-income Californians, with the federal government covering much of the cost. The expansion would be a boon to counties, which collectively spend billions of dollars caring for the indigent uninsured. One sticking point, though, is what to do with the more than $4 billion in sales taxes and vehicle license fees the state has been sending back to counties every year to help pay for public health programs -- and that the Brown administration wants to reclaim. Last week a group of nonprofits offered a sensible compromise, proposing that counties keep the funds if they spend them on a more efficient way to deliver care to the needy (5/12).

Boston Globe: A Trust Fund For New Medicaid Funding
In 2014, the federal government will send hundreds of millions of dollars to Massachusetts to help pay for an expansion of Medicaid under the terms of the Affordable Care Act. How we use those Medicaid funds will influence whether the state will have the financial resources to sustain that expansion over time. The first step in assuring the Medicaid funds are spent properly and as intended by Congress is to segregate them from the general funds of the state. This should be done by placing the new Medicaid revenues into a trust fund that would be dedicated to support Medicaid and other low-income health care programs. It is an idea that makes sense to many consumer, labor, business, and health care leaders (Lynn Nicholas, 5/11).

Lexington Herald-Leader: Medicaid Expansion Right For Ky.; Now Beshear Must Make It All Work
We could trot out other depressing indicators -- from frequency of diabetes to tooth decay -- to explain why Gov. Steve Beshear made the right choice -- the only choice, really -- by expanding Medicaid. ... But here's something that should be even more moving: Universal access won't make a significant difference in Kentuckians' health unless health care changes. Some good ideas are swirling around, but they won't take shape without strong leadership from the state, and that means Beshear. Much of Kentucky already suffers from shortages of primary care. Preparing a medical home for every Kentuckian will take hard work, from the loftiest medical faculty to the community and technical colleges, in order to create the capacity and work force to meet the new demand. The whole system must become more efficient and quality conscious (5/12).

The (Columbia, S.C.) State: Medicaid Madness
Democrats want free Medicaid for the working poor for the next three years; Republicans don't want it, and since Republicans are in complete control in our state, we won't get it, at least not the first year of it. ... when you listen closely to what opponents say, you realize that the opposition stems from their fear that our state couldn't accept just the three-year expansion and then return to the status quo before the federal government started sending us a bill. ... It's a political problem -- a political problem that Republican legislators and the governor have decided to throw away nearly $1 billion next year in order to avoid. They're worried that they won't be able to muster the political support to cut off the Medicaid spigot once it's turned on. ... Talk about not having much confidence in the strength of your own ideas (Cindi Ross Scoppe, 5/12).

Tulsa World: Medicaid Standoff A Disservice To Oklahomans
Does anyone else see the massive irony in Gov. Mary Fallin's latest attack on the Obama administration? She accused the president of not keeping his word and of "actively" seeking to toss 30,000 Oklahomans off a state-subsidized health-insurance program, when she has had it in her power for many months to singlehandedly provide health insurance for an estimated 180,000 residents by next year. Thanks to Oklahoma's inaction, the Insure Oklahoma program really is in jeopardy (5/13).

Cleveland Plain Dealer: Ohio Legislators Should Get Moving On Expanding Medicaid
If Ohio's skittish General Assembly keeps dawdling, voters themselves may be asked to extend Medicaid coverage to hundreds of thousands of Ohioans who now rely on expensive emergency care or care provided by Ohio taxpayers. Given the broad support for Medicaid expansion in Ohio, there shouldn't have to be an expensive referendum campaign to adopt it (5/11).

And in comments about the recent New England Journal of Medicine study of Medicaid in Oregon -

Forbes: Four Reasons Why The Oregon Medicaid Results Are Even Worse Than They Look
For years, lefty health policy wonks have insisted, against all the evidence, that expanding Medicaid would save hundreds of thousands of lives, and that, therefore, opponents of the Medicaid expansion are guilty of a form of mass murder. So it's been interesting to watch their reaction to the Oregon Medicaid study, which found that the $450 billion-a-year program "generated no significant improvement in measured physical health outcomes." They've desperately scoured the study to trumpet any silver lining they can find. But the reality is that the Oregon findings are even worse than they look. Here's why (Avik Roy, 5/11).

The New Republic: What Oregon Really Told Us About Medicaid
But the idea that this study all but blows away the case for the Medicaid expansion, as some Obamacare critics have suggested, still strikes me as wrong-headed. And that's because these critics make two unfair claims: that the study "proves" Medicaid doesn't improve health and that financial security, which Medicaid clearly provided its Oregon beneficiaries, was an afterthought in the health care reform debate (Jonathan Cohn, 5/13).

Tampa Bay Times: Medicaid's Benefits Not Easily Dismissed
A new study about the effectiveness of Medicaid in Oregon is being cited by opponents of expanding Medicaid in Florida and elsewhere, who complain the government health insurance program for the poor is a waste of taxpayer money. In fact, the results are more nuanced and suggest there are positive benefits as well as areas that need more study. The findings that Medicaid recipients enjoy lower rates of depression, increases in preventive health care and gains in financial stability should not be so easily dismissed (5/11).