Stick to facts on Medicaid

The Denver Post’s John Ingold engaged in one of the greatest acts of journalism this month — factchecking political claims.

The claim, among Republican candidates for governor, is that the Affordable Care Act’s expansion of Medicaid to ablebodied adults making more money than previous income limits is hurting Colorado’s budget.

Ingold explained how that’s simply not the case. In fact, the federal government still pays 90 percent of the Medicaid expansion population, and the remaining 10 percent is raised from a fee on overnight stays in the hospital that is earmarked specifically for the expansion population.

If the next governor undid Gov. John Hickenlooper’s Obamacare-embracing decision to expand Medicaid to more Coloradans, it would have very little impact on the state budget (outside of weird workings with the Taxpayer’s Bill of Rights, a problem solved with bipartisan agreement in 2017).

GOP primary candidates ought to keep that in mind headed into 2018 and perhaps modify their talking points so that they reflect reality. Because it’s true that spending on traditional Medicaid, which is predominantly for pregnant women, children, elderly in long-term care and the disabled, is skyrocketing. The problem is, it’s much easier to blame able-bodied adults for their drain on the state coffers than it is to point a finger at the children and disabled individuals and suggest budget cuts need to be made. Thus is perpetrated the Colorado Obamacare lie (although it’s important to note that federal money comes from somewhere).

An honest conversation about how to reform traditional Medcaid spending is very difficult, as Ingold also points out by illustrating that people with disabilities and in nursing

Second Opinion

homes make up 10 percent of the Medicaid population, but account for 42 percent of the state Medicaid spending.

Democrats have got to be willing to engage in that conversation in 2018, too, because Medicaid spending is having an impact on the state budget — even if it’s not being driven by Obamacare.

Ingold found that in fiscal year 1999-2000, Medicaid made up about 17 percent of the general fund budget. Today, it’s up to 26 percent.

The increase in spending has been due in part to people realizing they qualified for Medicaid when they went to enroll for the first time in a health insurance plan as required by the Affordable Care Act. Republicans should take note of this population that was clearly working, paying taxes and not on a government health care plan for which they could have qualified. This population makes so little money that paying for insurance in the private market — even, hypothetically, with subsidies keeping the price at 10 percent of their income — would be impossible.

But it’s also simply due to the rising costs of health care. Serving the same number of people for the same ailments has simply become more expensive.

Both of those problems, rising populations and increasing costs, are not easy fixes. At the heart of the problem are vulnerable populations of people who rely on the government for their health care. Fixing Colorado’s Medicaid problem will be complex and involve analyzing massive amounts of data to figure out policy changes that could bring more efficiency while not eroding care.

It’ll also require heart and strength and experimentation, nuance and conversation and honest debate.

We hope some of the candidates for governor — Republican and Democrat alike — are up for the challenge.