Using Medicaid as a Key to Driving Down the Cost of the Affordable Care Act

As many times as Republican federal legislators have tried to repeal, the Affordable Care Act (often times characterized as Obamacare) survives. The intent of the Affordable Care Act is to provide healthcare access to people who otherwise aren’t able to afford it. During the 2012 election, an argument was consistently presented by high profile Republican candidates that health care coverage for the otherwise uninsured should be achieved via state run programs through Medicaid. What was left out of the conversation is that such an endeavor would require a greater commitment by many states to expand Medicaid coverage.

In 2013, Texas has begun to put its money where its mouth is on the issue, and is now experiencing growing pains. As noted in an article by the Dallas Morning News , the state legislature has added an amendment to the bill that would otherwise have effectively allowed more people access to the Texas Medicaid program. The bill increases legislative oversight, which would increase input into the bill, but also bars the state of Texas from accepting anyone into the program after December 31, 2013 unless they meet requirements that may be outdated. This means, that in order for Texas’s Medicaid expansion to have any palpable effect, it has to be approved by the legislature no later than the end of 2013. The article did not suggest any signs that this would occur.

If politicians wish to place state run programs in the forefront to drive down the cost of the Affordable Care Act, they cannot then fight the expansion of the state run programs. This would result in more Americans choosing the Affordable Care Act, the same way they would choose a cheaper private health insurance if it provided the coverage they need. Simply put, if politicians want taxpayers to drive down the cost of the federally funded healthcare programs, then they have to make the state run healthcare programs compete in the market for the otherwise uninsured. Texas efforts, to some extent, can be applauded, but if the legislation isn’t expedient enough under their own amendment, it won’t be effective.

Failure to have either state or federal solutions in place to help the uninsured can spell health related disaster for the uninsured, and eventual financial disaster for the taxpayers. Failure to have access to healthcare causes many people’s conditions to worsen to the point where they may not be able to work anymore. It may even cause death. From a taxpayer standpoint, failing to allow people access to healthcare increases the demand for programs like Social Security Disability and Supplemental Security Income, as it increases the number of disabled citizens, who could otherwise return to work if they had better healthcare access. It also decreases the overall tax base to the Unites States, as less people would be able bodied enough to work and pay income tax, decreasing tax revenue. The United States Gross Domestic Product can additionally decrease as the workforce can decline due to untreated conditions, allowing Americans to produce and export less. Helping the uninsured get the healthcare access they need is NOT charity, it’s an investment.

The Affordable Care Act has been demonized since its passing due to the expense on the American taxpayer. If the solution truly lies in the state run Medicaid program, then it’s time for state legislatures to allow the program to step up, be accessible, and ease the burden on taxpayers.