Friday, April 3, 2015

ACA/Obamacare and the Medicaid Expansion Component

“Medicaid enrollment has surged 19% nationally since ObamaCare’s expansion—50% in New Mexico, 65% in Oregon, 81% in Kentucky—and spending is exploding. So taxpayers ought to be grateful that the Supreme Court declined 5-4 on Tuesday to convert this entitlement—and all the others—into a private right.

Medicaid, the joint state-federal program originally meant for the poor and disabled, sets price controls for all health-care services. And in the law that created the program, Congress instructed the states to “assure that payments are consistent with efficiency, economy, and quality of care and are sufficient to enlist enough providers” equal to those available to the general population. In Armstrong v. Exceptional Child Center, a group of in-home care companies sued Idaho for setting reimbursement rates too low, thus purportedly violating this amorphous standard.”

“Medicaid’s fire-sale reimbursement rates often result in inferior care and distort markets, but they might be more generous if the program was limited to its original purpose of helping the poor. Also recall that Medicaid is an entitlement for providers as much as beneficiaries, and they don’t have to participate.

Armstrong was a backdoor bid to reflate the judicial rate-setting that providers have long sought but the Court rebuked in 2002 in Gonzaga v. Doe, holding that spending programs do not create judicially enforceable rights like those in the Constitution. So mark this one down as a victory for judicial and fiscal restraint.” - Close Encounters of the Medicaid Kind, WSJ, 04/01/2015

Link to the article appears below:

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