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December 23rd, 2009 7:07 pm
Pass Health Care “Reform,” Kill Medicaid?

While options for defeating health care “reform” are dwindling for congressional Republicans, there may be another, better collection of politicians to derail the federal government’s looming takeover: state governments.  It bears remembering that for all the talk of health care being a human right, the vehicle through which it will be delivered is a voluntary agreement exchanging state sovereignty for federal dollars.  Say no to the federal dollars by opting out of Medicaid, and states are free to provide health care at a price their taxpayers can afford.

That’s the gist of the argument made by two analysts at The Heritage Foundation and discussed today in an article posted on Human Events.  Granted, it may seem like a health care bill passed by Congress and signed into law by the president is immediately binding on the states.  But only if states refuse to opt out of Medicaid.  Like all state-federal “partnerships”, state governments take federal tax dollars because it’s popular to spend money, and besides, a state might as well get back some of what it pays to Washington, right?

Maybe not.  Instead, governors and state legislators would do well to seriously consider saying “no thanks” to Uncle Sam and looking for ways to deliver the same or similar benefits using state-only dollars.  According to the same Heritage Foundation study:

If all states withdraw from Medicaid, their collective savings would be $725 billion over the 2013-2019 period, but they would exceed $1 trillion over 10 years. This assumes that states will continue to spend at least 90 percent of what they spend now on Medicaid long-term care services with state-only dollars. On a state-by-state basis, every state except North Dakota would come out ahead financially by leaving Medicaid but continuing long-term care spending with state-only dollars. Of course, if North Dakota reduced its long-term care spending, it too would come out ahead.

With Senators Mary Landrieu (D-LA) and Ben Nelson (D-NE) challenging their governors to take their Medicaid carve outs or pay the full price of “reform”, now is the time for states to start thinking how to regain their status as “50 laboratories” and let all that federal tax money go to some other cause.  Deficit reduction, anyone?

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