To defeat Medicaid expansion all you have to do is lie

(Opinion) – Do you believe that the people who would be on expanded Medicaid right now if it hadn’t been rejected by the Wyoming Legislature are lazy bums who would rather get welfare than work for a living?

Or that the 31 states that expanded their Medicaid programs all regret it because it either bankrupted them or forced their lawmakers to raise taxes and cut education? And that expansion has on balance led to the poor receiving worse health care than they had before?

Congratulations! You have been duped by the biggest misinformation campaign the Equality State has ever seen. It’s too late to change one of the most damaging decisions our state lawmakers have ever made, but you can still know the truth.

Here’s what Wyoming will lose because the Senate, for the fourth year in a row, sold out their constituents to make an empty anti-Obama political gesture and voted 20-10 to kill Medicaid expansion last Friday:

— Health insurance coverage for 20,000 low-income Wyoming residents.

— $33.5 million in savings from other social service programs.

— $268 million that Wyoming could have used to offset the more than $447 million budget deficit for the next two years.

The Legislature also lost something intangible, literally priceless, on Friday: its integrity.

Voters send people to Cheyenne to do their best for the state, not forsake the poor and unfortunate. But that’s exactly what 20 of them did, and if the House had bothered to even vote on the issue, there’s no doubt at least 40 more would have done the same thing.

Perhaps you heard Sen. Charlie Scott (R-Casper), the Legislature’s leading opponent of Medicaid expansion, use the podium on the Senate floor to once again spew stacks of misinformation. This year he outdid himself, calling the program “a welfare bureaucracy of the health department” and comparing it to bondage.

His plea to kill expansion included some of his most ludicrous claims yet. While Scott has long
expressed fear that Medicaid recipients could “over-utilize” health care services to get unnecessary tests and procedures performed, his charges sunk to a new low Friday.

Scott derisively called the 20,000 people who would be helped “a small number.” The senator actually said if people knew they could get Medicaid, they would retire early so they could live off the government. Long-time observers of the senator might ask “retire from what?” since Scott always describes the people who would finally be able to get health insurance through Medicaid expansion as “able-bodied” men and women who refuse to work.

Here’s the truth. About 60 percent of those eligible for the expanded program do work, usually at minimum-wage jobs that don’t offer health benefits. Some work at two or more of these jobs trying to cobble together enough money to survive.

Many of the remaining 40 percent are sick and can’t work because — guess what? — they don’t have adequate health care because they are too poor to afford it.

The 20,000 Wyomingites who would receive Medicaid if the state would approve it make less than $15,800 a year. I’d like to see Scott and the 19 other senators who voted against expansion try to live on that amount and take care of their families, even if their health insurance was fully paid by the government.

Retire because they can finally get health insurance? Retirement is just a dream for those stuck on the bottom rung of the economic ladder. Even if they were able to obtain adequate health care, the bills for food, housing, transportation and other essentials remain. Wyoming’s least fortunate inhabit a never-ending cycle of debt and despair.

Scott incorrectly claims that about half of those eligible for Medicaid expansion already buy health insurance, and those who don’t can easily get subsidies from the federal government to purchase policies on the health marketplace. Rep. Don Burkhart (R-Rawlins), one of Scott’s disciples, told me the latter don’t have to pay any money at all for health insurance, so why are we worried about them?

Here’s why. About two-thirds of the 20,000 fall into the “Medicaid gap.” They would be eligible to enroll in Medicaid if expansion was approved, but that assistance obviously isn’t available. They do not qualify for premium tax credits under the Affordable Care Act (“Obamacare”) because they don’t earn enough. This population, as Mike Fierberg, media relations director for the Centers for Medicare and Medicaid Services in Denver, told me, is simply out of luck until their state decides to rescue them.

They’re not alone. Nationally nearly 3 million people in the 19 states that refused federal money to expand Medicaid fall into the gap. Their states are sacrificing them to protest the ACA. That means a lot of Charlie Scotts out there have been successful in their legislative rants against Medicaid expansion.

But they can’t do it alone; they are helped by far-right organizations like the Wyoming Liberty Group, the Foundation for Government Accountability and other opponents. The latter is a front for the infamous American Legislative Exchange Council, which has its state lawmaking minions do its Tea Party bidding in state capitols around the country. ALEC, in turn, is funded by the billionaire Koch brothers, who have made it their mission to take every social service program in America and crush it into dust.

The FGA recently ran a radio smear campaign against Medicaid expansion throughout Wyoming. Many of its claims, such as Wyoming would be forced to raise taxes or cut education, roads and public safety, were expertly debunked in an article by Casper Star-Tribune reporter Laura Hancock.

The Wyoming Liberty Group published an article on its website by Charles Katebi, “Saying No to Medicaid Expansion Saves Hospitals and Lives.” If you fired a pistol every time you read a piece of misinformation, you’d be deaf before finishing.

Katebi claimed expansion added so many people to Medicaid rolls it has forced states to cut payments to hospitals, “blowing huge holes in state budgets that legislators had to fill, and leaving many patients waiting for care.”

Katebi said the influx of Medicaid patients has cut off access to doctors. “Medicaid patients often develop conditions that go undetected and untreated until it’s too late,” he said. “After surveying cancer patients, doctors at the University of South Florida found that Medicaid patients were 31 percent more likely to have late-stage breast cancer and 81 percent more likely to have late-stage melanoma than patients without any insurance at all.”

His argument is that patients who have no health care at all are less at risk than those who see a doctor. In reality, the lack of access to health care caused by states that have refused expansion has made it nearly impossible for most of the working poor to get the preventative health care needed to diagnose disease in a timely fashion.

Healthy Wyoming is a broad coalition of state businesses, labor unions, medical associations, hospitals, church groups and social service workers. It cites an Oregon study that notes people with Medicaid are 40 percent less likely to have suffered a decline in health in the previous six months, compared with similar people without health coverage.

After two years of opposing expansion, Republican Gov. Matt Mead recognized the state can’t afford to leave 20,000 people at risk while throwing away more than $310,000 a day in federal dollars. In a statesman-like move he put Medicaid expansion in the Health Department’s budget, but GOP legislative leaders slashed it.

Republicans cut the Family Literacy program and the Tax Rebate for the Elderly and Disabled. They reduced school funding, including money for early education programs. The GOP couldn’t expand Medicaid and help the poor, but they did find one program worth saving.

It was the $8 million match earmarked for the University of Wyoming’s “athletic competitiveness” program. Our poor don’t have health care and our children can’t read, but thank God we can all take pride in our football team. Those sick, retired lowlifes who live off the government won’t be able to afford a ticket to see them play, of course, but as two-thirds of our illustrious Senate made unmistakably clear, who really cares?

— Columns are the signed perspective of the author, and do not necessarily reflect the views of WyoFile’s staff, board of directors or its supporters. WyoFile welcomes guest columns and op-ed pieces from all points of view. If you’d like to write a guest column for WyoFile, please contact WyoFile editor-in-chief Dustin Bleizeffer at dustin@wyofile.com.