Published Tuesday, February 26, 2013 at 1:00 am / Updated at 3:10 pm
Midlands Voices: Reject costly expansion of Medicaid

The writer is state director of Americans for Prosperity-Nebraska.

Jan. 1, 2014, is an important date just around the corner. That is when most of the president’s health care law will go into effect. One of the key components of the law is the vast expansion of the Medicaid system, which cannot be done unless states voluntarily participate. Nebraska legislators should ignore the president’s calls.

The U.S. Supreme Court said this gigantic expansion, covering 12 million Americans, could not be forced by the federal government, putting states in the driver’s seat.

The federal government is begging states to cooperate by offering to fund 100 percent of the costs for Medicaid expansion for the first three years. After that, the states will be asked to take on a percentage of the cost.

Unfortunately, there is a group of Nebraska state senators buying this concept that federal money is “free money.”

Federal money is not “free money,” it’s taxpayer money. It’s our money.

The federal government is more than $16 trillion in debt, and neither the president nor Congress has shown much willingness to lead and solve this enormous problem. Relying on the federal government to fund expanded entitlement spending would put our state budget in a precarious situation.

While promises of federal funds for Medicaid expansion are made today, that is no guarantee of funding in the future.

In 2011, President Barack Obama proposed $72 billion in Medicaid cuts, reducing the federal support of state Medicaid costs by $15 billion. In 2012, the president again proposed cutting $70 billion from Medicaid by revising the federal match to state Medicaid programs. And the White House 2013 budget proposes to cut $351 billion from entitlement programs over 10 years.

When the federal government is forced to confront its spending problem — whether during the debt limit crisis of 2011, the fiscal cliff crisis of 2012 or the sequestration crisis of 2013 — entitlement programs, and the Medicaid program specifically, are routinely scrutinized for cost savings.

Current entitlement spending is unsustainable, and expanding the Medicaid program as allowed by President Obama’s health care law and proposed by State Sen. Kathy Campbell would only put the program at greater risk.

Medicaid expansion would cost the federal government $930 billion from 2014 to 2022. It is unknown how the federal government can fund nearly $1 trillion in additional spending without gradually shifting those costs onto the states.

The cost of Medicaid expansion in Nebraska would be devastating to our state budget. Gov. Dave Heineman estimates that Medicaid expansion would cost Nebraska as much as $766 million over 10 years. And if the federal government does reduce the federal Medicaid match, that number could go up dramatically.

Increased entitlement spending is neither practical nor ethical. Expanding entitlement programs by $1 trillion would bankrupt our social safety net and prohibit government from providing support for those who truly need it.

While providing access to affordable health coverage for all Americans is a laudable goal, simply expanding government programs and adding to our already-unmanageable federal debt is not the right approach.

Unless we put our fiscal house in order, the federal government will run out of money to spend — and Nebraska’s taxpayers will be stuck footing the bill.

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