When our State Legislature chose not to expand Medicaid coverage last year, it made the national news. See how one vote killed Medicaid expansion in Montana, and it was a mistaken vote http://www.washingtonpost.com/blogs/wonkblog/wp/2013/04/24/accidents-happen-how-one-mistaken-vote-killed-montanas-medicaid-expansion/
Medicaid expansion would have allowed Montanans making slightly more money than the federal poverty rate to receive Medicaid benefits (as an alternative to purchasing private health insurance coverage). This became newsworthy because our state’s decision was ultimately caused by one legislator’s vote-casting accident. While that is pretty remarkable all by itself, equally remarkable is the flood of errors and misleading information about the issue that engulfed us along the way. After all, Medicaid expansion would have addressed one of our biggest concerns about requiring all Americans to have health insurance. It would have directly benefited those Montanans living just above the national poverty rate—those who have to choose between $100-$150 worth of groceries each month and their health insurance bill.
What accounts for the reluctance of Montanans to support Medicaid expansion in our state? It seems the campaign of misinformation around Affordable Care worked well here. Last year our own NEWS picked up on this in “Opinions divided on Medicaid expansion.” http://bighorncountynews.com/archive/2013/week%2013/story2.html
Two different studies were cited that pointed to vastly different outcomes in states that did expand Medicaid coverage. One study found worse surgical outcomes for Medicaid clients than for patients with private insurance. Another found increased life expectancy for Expanded Medicaid recipients (3% decrease in fatalities for 20-64 year olds in New York, Maine, and Arizona).
How confusing! It turns out that both stories are true, but the devil is in the details, as the saying goes. The first study didn’t take into account the fact that Medicaid recipients receiving surgery were in worse shape to start with (largely as a result of living in poverty). Those with private insurance had better results from surgery because they had more access to preventative care all along. It’s interesting that those of us who don’t do research studies for a living can see right away that this comparison is bogus. How did those professionals at the University of Virginia miss it?
The Gazette this past Friday quotes a U of M economist, who, with similarly sly bias, notes that “thousands of jobs” will “cost tax payers millions.” http://billingsgazette.com/news/local/economist-rapid-changes-in-health-care-mean-jobs-for-billings/article_572a4d32-20b4-5c6f-81ab-9f26af797ed3.html
The remainder of the story leaves the reader with a challenging task of connecting disconnected information to understand the full picture. Medicaid expansion through 2021 in Montana could “cost taxpayers about $34 million.” That full amount will be incurred over the span of seven years, while along the way creating 14,000 jobs statewide. That calculates to under $400 of taxpayer investment yearly for each of those high paying health sector jobs. When you think about the overall gain in state revenues that would come from these jobs, it’s hard to imagine a better investment for our state.
Now when this amount of misinformation gets deliberately spun around an issue that would seem to benefit so many ordinary, working-class Montanans, it makes me wonder about money. Who would stand to benefit by manipulating the issue in this way? It turns out that the most likely alternative to a simple Medicaid expansion in Montana will almost certainly release federal funds to our state’s private insurance companies. They can then limit health coverage for their own profit. This mostly affects Montanans working hard to stay out of poverty, those families who manage financial independence until it comes to over-priced health insurance costs. When wealthy executives of these companies stand to enrich their already-overflowing coffers, can we expect them to be honest with the facts?
Follow the money trail to learn the truth about this, and how so many issues in our state get confused when the facts on their face seem so clear. Several good sources highlight the media control of dialogue on important issues, clouding those issues with well-financed bias. Here are some on this issue:
http://www.dailykos.com/story/2014/04/06/1290119/-MedicAid-Expansion-Follow-the-Money
David Graber
Hardin, MT
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