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Public Statements

Obamacare's Medicaid Problems


Location: Washington, DC

By Representative John Fleming

Obamacare has received critical scrutiny from our nation's highest court. Skeptical Supreme Court Justices questioned the government's power to force you to buy a product. I believe Obamacare is unconstitutional. If it's not overturned, it must be repealed.

But the litigation produced a stunning remark from Justice Elena Kagan, who cheered for Obamacare when it was pushed through Congress. Justice Kagan was the administration's Solicitor General before she was nominated to the Supreme Court.

During Wednesday afternoon's hearing, Justice Kagan was incredulous toward the argument that states are coerced by Obamacare's Medicaid expansion. "…why is a big gift from the Federal government a matter of coercion?" she asked, "…it's just a boatload of Federal money for you to spend on poor people's healthcare. It doesn't sound coercive to me." She tried to illustrate her point by role-playing with the attorney and saying it would not be coercive to offer him a job that paid $10 million a year. But he wisely didn't play along, and pointed out that it wouldn't be such a great deal if the money he was being paid was actually his in the first place.

That's the issue. Medicaid money is not a "big gift" to states. Obamacare's Medicaid expansion IS coercive. It is a boatload of your tax dollars and mine, and it comes with expensive strings attached.

I've dealt with Medicaid for about 36 years, first as a doctor treating Medicaid patients, and then in Congress, trying to reform a broken system. Under Obamacare, the federal government expands the Medicaid rolls, forces additional requirements on states, provides only part of the funding to run it, and then mandates that states supply the balance, or lose federal dollars. The system's low reimbursement rates have also forced out doctors, making it harder for patients to find care.

For years, I've studied the subject of addiction, the terrible process that can enslave people to drugs and alcohol. Drug dealers will cruelly give away their product to get someone addicted and to entrap him as a customer with a need for more. That's a sad metaphor of what the federal government is doing with Obamacare and Medicaid. They inject the needle of "free money" into the veins of the states and then make it impossible for states to withdraw, all the while demanding that states spend more and more to keep the program going. Over time, the federal money is rapidly withdrawn, leaving the states to pay for huge, costly mandates that will send them into bankruptcy.

We have two choices for confronting this cynical crisis. Some, like Senator Mary Landrieu, who remains fully committed to Obamacare, play the Washington game for more federal money; more of your hard earned tax dollars. I believe it's time for real reform. We can either save the program through smart changes that cut costs and help patients, or stand by and watch as that "boatload of Federal money" sinks in a sea of debt and leaves states high and dry.

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