There’s very little that right-wing opponents of President Obama and the Affordable Care Act aren’t willing to claim in public about America’s increasingly successful and transformative health care law. From “death panels” to imaginary massive tax hikes to allegations about global conspiracies and plots to impose martial law and suspend the Constitution, the loony conspiracy theories are as endlessly creative as they are delusional.
As a general matter, the kookiness does seem to be somewhat on the wane of late as the ACA slowly but surely moves millions of new people onto the insurance rolls while helping to contain the growth in health care costs. Heck, even the McCrory administration has finally recognized that North Carolina must expand Medicaid under the ACA.
For a few true believers and unrepentant, whatever-it-takes propagandists, however, the battle is still on and just about any anti-Obamacare claim — however preposterous — will do. For a classic example, check out this post by a staffer over at the Locke Foundation entitled “Medicaid Expansion Could Steer Resources Away From the Most Vulnerable.” Here, as best as can be determined, is the “argument”:
If North Carolina expands Medicaid to cover hundreds of thousands of uninsured, lower-income people, the cost of doing so will be born almost exclusively by the federal government. The feds cover 100% of the tab for the first three years and by the year 2020, will still cover 90% of the cost. (So far,so good — everyone has long understood this to be the case. Indeed, it’s one of the big selling points of the law.)
Here, however, is where things get weird. According to the Locke people, if the General Assembly chooses to cut state spending on Medicaid after the year 2020, it would lose $9 in federal match for every $1 it cut for the folks covered by Medicaid expansion. Therefore, goes the argument, if the state sought to cut Medicaid spending, it would be more inclined to cut services to other program beneficiaries, for whom the match rate is only two-to-one today (i.e. the feds provide a two dollar match for every state dollar spent).
Therefore (still following this?) expanding Medicaid today for some poor people at a 90% federal reimbursement rate jeopardizes current Medicaid recipients six years from now for whom the feds currently only pay 67%.
We’re not making this up: The Locke Foundation — a group that has argued vociferously for decades in favor of cutting Medicaid and slashing “optional” Medicaid services like prosthetic limbs and ambulance services to desperately poor people (i.e. the ones for whom the feds pay 67% of the cost of serving) — has now, all of a sudden, gotten religion about helping “the most vulnerable populations” (or, at least the ones that will exist in the next decade). It’s hard to know whether to laugh or cry at this kind of “reasoning.”
The happy bottom line: Fortunately, this convoluted argument appears to be winning few adherents. As noted, the McCrory administration has finally come around on Medicaid expansion and, as has occurred with the debate over education (where the public has shown little faith in the claims of devotion to public education by politicians who spent years bashing it) few in the public are likely to fall for the notion that right-wing anti-government think tanks know best how to preserve a vital safety net program they’ve spent decades trying to undermine.