joedlrt wrote:
We should reverse many of the Biden and Obama era Medicaid expansions and reduce the subsidies for Obamacare to match the taxation expansions enacted to fund them. The combined programs were not designed with adequate funding mechanisms and should be adjusted accordingly. Even if you exclude the COVID expansion and subsequent rollback, Biden and Obama added 33.8 million Americans to Medicaid (a 71.6% expansion during which time the population only increased 11%). Annual Medicaid costs rose $472 billion between 2008 and 2022 (from $352 billion to $824 billion, a 134% increase). Obamacare subsidies add another $125 billion a year. So you have these two expensive programs costing about $600 billion extra per year over the 2008 baseline with maybe enough revenue from the enacted taxes to cover the subsidies, but nothing to cover the Medicaid expansion. Federal revenue is not the problem. Expenditures are the problem.
You’re referring to “the problem” from legislation with a laundry list of problems, about which you can find reasonable arguments putting the blame on both Republicans and Democrats — each needed the compromise of half a loaf, and special interests ran amok.
And we don’t have the counterfactuals to really determine what might have been better.
But if you want to consider how costs proliferated in a few years following, consider this — you have a population without affordable access to routine healthcare for years, and they now have health insurance. What do you think their need and usage rate will be out of the gate? Do you think risk assessment was good at your major insurers? Where you had people with realistic expectations, do you think their professional incentives aligned with the following “truth-to-power” statement: Hey y’all, we need to smack down our members or we about to get hosed? (Obviously the way the market goes for the next open enrollment, “smack down our members” means Catch-22, not either-or).