I support Gov. Terry Branstad's decision to not expand Medicaid in Iowa.
First of all, the federal government is broke. Its debt, as I write this Tuesday afternoon, is $16.5 TRILLION. Meanwhile, instead of dealing with this like responsible stewards of taxpayer money, Congress chose to put off a debt “ceiling” (let's face it, there's no point in setting one, they will just keep increasing it) for a few months with a gimmick that their pay will stop if the fail to pass a budget.
As if either of those things – a pay stoppage for elected officials or the Senate passing a budget after waiting four years – will happen.
Second of all, our unfunded liabilities (promises made that will never possibly be kept) are at $122 TRILLION. Of that, there is an $85 trillion Medicare liability. Our total national assets are at $93 trillion. Does it seem like a good idea to expand federal medical insurance liability?
Third of all, doctors in Iowa are not reimbursed the proper rate from federal health care programs because they, and the hospitals in which they serve, are too efficient. The federal government, in its infinite wisdom, has a history of rewarding inefficiency. The more poorly a medical facility runs, the more money it receives. I believe Iowa's reimbursement rates were supposed to increase, thanks to Obamacare, but I'm not sure how much. I doubt if the extra money would make the extra work, which Medicaid will likely create, worthwhile.
Fourth of all, which kind of touches on my previous point, if more people think their health care costs are “free” or won't hit THEM in the pocket, they're more likely to visit the doctor for things that a Tylenol or a bottle of cough medicine could solve. In rural Iowa, access to medical professionals is already at a premium. More appointments will stretch their resources even further, thus causing more of a decline in the quality of care.