From the St. Louis Post Dispatch this morning, here is my Letter to the Editor where I argue against Obamacare Medicaid expansion. Here is the link, and the text of the letter is below.
In a commentary Jan. 14, Steven Lipstein, CEO of BJC HealthCare, argues for Medicaid expansion under the Affordable Care Act.
Why do Missouri and 22 other states refuse to go along with Obamacare Medicaid expansion, resisting the pressure of activists and hospitals?
Many have urged us to take the “free money” offered to expand Medicaid. It is argued that Missouri taxpayers’ money is going to other states. This is simply not the case. There is no federal lockbox containing Missouri money. With a $500 billion federal deficit and an $18 trillion debt, Obamacare expansion money is money borrowed from China, money which our children and grandchildren will have to repay.
In addition, Obamacare Medicaid expansion would cost Missouri taxpayers tens of millions of dollars just to administer putting 300,000 able-bodied, working-age Missourians on Medicaid. And in time, Missouri’s 10 percent will amount to hundreds of millions of dollars, straining our Medicaid program at the expense of the children, elderly and disabled who truly need it.
Mr. Lipstein cites struggles of Missouri hospitals. Indeed, many hospitals were already struggling financially, and Obamacare’s Medicare and DSH cuts make things worse. Hospitals were major supporters of Obamacare; they agreed to these cuts because of Medicaid expansion, which the U.S. Supreme Court decided is optional for the states. Hospitals should join in the fight to repeal Obamacare, and in the process restore these cuts.
He complains about the “costs of caring for the uninsured in Missouri hospitals.” But remember that provision of care to the poor is why federal, state and local governments consider BJC and most other hospitals to be nonprofits and exempt them from taxes. As Lipstein complains about the costs of uncompensated care, BJC plans a $1 billion expansion and pays him a salary of $6.6 million per year.
Lipstein encourages Missouri to follow our neighboring states in implementing an Obamacare Medicaid expansion. But our neighbor Illinois teeters on the edge of bankruptcy, and Arkansas is likely to undo its Medicaid expansion in 2015.
Mr. Lipstein calls for “open minds.” I would suggest he keep an open mind that the ACA might be part of the problem, not the solution.
State Sen. Robert F. Onder * R-Lake Saint Louis