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Expand Medicaid? NO: It’s a question of care, not coverage

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Posted: Sunday, August 18, 2013 12:00 am

The Medicaid Innovation and Reform Commission will meet tomorrow for a second time to discuss expanding Medicaid, the government insurance program that is supposed to help the poor and is a key part of Obamacare. Over the past few months the media and the Virginia political establishment have framed the debate to expand Medicaid around coverage. Obamacare proponents and the media have touted that an estimated 400,000 Virginians will receive some form of health insurance coverage if the commission supports Medicaid expansion. However, nobody has asked what kind of care those Virginians will receive with that coverage.

The evidence overwhelmingly shows that Medicaid expansion will mean a dramatic drop in the quality of care. The most important part of any health coverage plan is access to high-quality care and the ability to forge a one-on-one doctor-patient relationship. These are the doctors who help us most to prevent disease and sickness. These doctors are who we turn to when our kids have the chicken pox, when mom or dad has arthritic flare-ups or, God forbid, when our significant other has symptoms of cancer. They’re the ones we trust. They’re our first line of defense. Unfortunately, Medicaid expansion could destroy that relationship.

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According to a survey conducted by the National Center for Health Statistics, nearly 1 in 4 Virginia doctors do not currently accept new Medicaid patients. If more individuals are forced into the already broken system, undoubtedly that number will rise. This will mean fewer doctors in a coverage network, longer waits to see a family doctor, and in some cases the possibility of being turned away at the office door.

A shocking study by the University of Virginia showed that Medicaid patients are 13 percent more likely to die during surgery than those with no insurance, and 97 percent more likely to die in surgery than those with private insurance. A study published in Cancer shows people over the age of 65 who are insured by Medicaid have a greater risk of late-stage diagnosis of various cancers, and therefore are at greater risk of premature death than even the uninsured.

Without access to quality doctors and preventative care as children and young adults, Medicaid patients are much more vulnerable to disease and illnesses like cancer as adults. Recently, PolitiFact wrote a “Truth-O-Meter” story about my statements on Medicaid expansion. The reporter only rated my statement “Mostly True” because the physician survey I cited didn’t include emergency hospital doctors — doctors, according to her, that are most likely to treat Medicaid patients.

She missed the point — and so has most of the Virginia media. The government can send plastic cards to 400,000 individuals letting them know that they have coverage. However, if a mom with Medicaid can’t find a doctor to treat her daughter’s seizures with that coverage, then what’s the point? The legislature’s goal should be to ensure all Medicaid patients have access to family doctors and quality preventive care, not encourage more families to receive primary care in the emergency room.

As the father of a 16-month-old baby girl, I never want to be told that a doctor can’t see my daughter when she is sick. Nobody, especially the most vulnerable among us, should ever be told “no” by a government bureaucrat. However, that’s exactly what could happen if legislators in Richmond approve Obamacare and Medicaid expansion. If this debate is about care, and how we treat the neediest Virginians, then Medicaid expansion should be dead on arrival in Richmond.

Dave Schwartz is the Virginia state director of Americans for Prosperity. Contact him at dave@afpvirginia.com.

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