Right-wing media have seized on a study of Medicaid recipients to attack the program by focusing on certain parts of the findings while health care experts point out that the program successfully expanded access to care and eased health-related financial problems, the primary focus of Medicaid.
In 2008, the state of Oregon held a lottery to expand Medicaid coverage to 10,000 people. Because the selection was random, researchers began a controlled study on how the coverage affected the participants. After the results were posted in The New England Journal of Medicine, right-wing media seized on the findings to attack both Medicaid and health care reform. On May 2, Fox Nation posted a Washington Examiner article on the study under the headline "Landmark Study Shatters Liberal Health Care Claims." In the article, Examiner senior editorial writer Philip Klein noted that the study's authors found that enrollment in Medicaid led to "lower rates of depression," but Klein wrote that "the study suggests that expanding Medicaid ... does not improve" the health of recipients. On Your World, Fox's senior managing editor for health news, Dr. Manny Alvarez, used the findings to attack the Affordable Care Act (ACA):
On May 3, Fox & Friends co-host Steve Doocy called the Medicaid study "[b]ad news for Democrats who support Obamacare." On-screen text during the segment stated that the study found that Medicaid is "ineffective":
But while Fox used the study as an opportunity to attack various aspects of health care reform, experts have pointed out that the study's findings, while not entirely positive, show that the program aided the new enrollees in several ways. In a Health Affairs blog post, Dr. John Lumpkin, who served for 12 years as the director of the Illinois Department of Public Health, wrote that the study showed that "coverage alone will not necessarily lead to good health," but also pointed to the "big impact on family finances" and the fact that "expanding Medicaid was shown to substantially reduce depression." Dr. Lumpkin concluded:
So far, the Oregon Health Insurance Study shows us that people who obtained Medicaid coverage received more health care services in the first two years--especially needed preventive care--and had less depression and financial worries. Their health outcomes weren't significantly better, but at least they are now participating in the health care system and getting the care they need, without plunging their families deeper into poverty. From this vantage point, the glass seems more than half full.
National Review Online attacked a program that would make released inmates eligible for Medicaid as an "expensive addition" to the program, despite praise from experts who have pointed to the policy's potential to cut health care costs.
An NRO post attacked a provision in the Affordable Care Act which would make recently released prisoners eligible for Medicaid benefits. The blog attacked the program as an "expensive addition" to Medicaid, later complaining that "monumental poor life choices, including the ones felons have made ... will be subsidized by" taxpayers:
Obamacare expands Medicaid enrollment substantially. To deny someone enrollment because he'd served time in prison would surely violate the underlying intent of giving everyone equal health care. And if affordable health care is now a right, to deprive former felons would be to impose a punishment in addition to their original sentence. So to some extent, felons' new Medicaid eligibility makes legal sense.
But there's nevertheless an annoying hypocrisy here.
As Bloomberg's recent soda campaign so aptly demonstrated, once health care becomes a public expense, personal choices become a public concern. Taxpayers can expect to be nagged about small poor life choices like opting for a bigger beverage or a higher-calorie meal choice.
But monumental poor life choices, including the ones felons have made -- which result in lower incomes and worse health -- will be subsidized by those same taxpayers.
It may be equal, but it doesn't seem very fair.
But experts have pointed out that the program could lead to an overall reduction in health care spending. A Pew Stateline article quoted proponents of the program who explained that making released inmates eligible for Medicaid would reduce medical costs by providing access to preventive care and reducing the use of emergency care as a primary health care provider:
Fox News host Neil Cavuto and Fox guest Stephen Moore agreed that President Obama is wrong to suggest that federal spending growth is driven by health care costs, when in fact Obama is right. Health care spending is the only category of federal spending projected to grow substantially over the next two decades, and government health insurance is actually more efficient than private sector insurance. And the president's Patient Protection and Affordable Care Act contains provisions that aims to contain and reduce national health care costs.
Bill O'Reilly seized on the story of a shoeless man who was helped by a New York City police officer to call for cuts to government programs that help the poor.
O'Reilly opened his Thursday show by recounting an incident in November in which Officer Lawrence DePrimo bought a pair of boots for Jeffrey Hillman, a man in Times Square who had bare feet. A tourist took a picture of the DePrimo giving the boots to Hillman, and the image was widely circulated on the Internet.
While Hillman was initially said to be homeless, it has since been reported that he has an apartment. O'Reilly presented this fact as if it were a devastating revelation -- "here's the sad truth," he said before informing his viewers that Hillman has a home. O'Reilly also claimed that Hillman "has enough resources to live his life in a dignified manner."
What O'Reilly did not tell his viewers is that Hillman was homeless prior to last year. Nor did O'Reilly mention that Hillman uses veterans benefits to help keep his apartment.
NBC New York reported, "Hillman used to be homeless, but entered shelter in 2009 before moving into an apartment secured by Veterans Affairs in 2011, city officials said. He pays his rent using a lifetime voucher for homeless veterans and his Social Security income."
O'REILLY: Obviously, Officer DePrimo is a patriot, but here's the sad truth. Mr. Hillman's not homeless. He has an apartment, paid for by you and me. He's on government assistance. He has enough resources to live his life in a dignified manner. Yet Mr. Hillman doesn't do that. He prefers the street. And the boots Officer DePrimo have gave him have disappeared. Now, I'm not judging Hillman. Most cases like his involve substance abuse or mental illness. However, we must be honest. The government cannot provide a decent life for Hillman, no matter how much money it spends. We're already giving the guy tens of thousands of dollars a year, and it is doing nothing. There are millions of Americans like Jeffrey Hillman, and we all need to understand that some people simply will not -- will not -- save themselves.
While O'Reilly claimed not to be "judging" Hillman because most "cases like his involve substance abuse or mental illness," he began the segment by saying that "[a]ll of us need to wise up, and fast," and went on to use his abridged version of Hillman's story to demand cuts to entitlement programs.
Ted Nugent called for the suspension of the right to vote for "any American who is on welfare" as part of his proposal to reduce federal budget deficits outlined in his latest Washington Times column.
The National Rifle Association board member also called for "slaughtering the three sacred entitlement cows" of Medicare, Medicaid, and Social Security, and called for tax increases on "the nearly 50 percent of Americans who pay zero federal income taxes." Nugent wrote that these policies should be instituted "before taxes are raised on the producers, which will further choke the economy."
From Nugent's column:
The three sacred entitlement cows in the room that no politician wants to poke are Social Security, Medicare and Medicaid. A blinding statement of the obvious is that we are never going to get our financial house in order until these sacred entitlement cows are not only poked, but slaughtered. Until the slaughter is over, everything else is just taxation window dressing.
In addition to slaughtering the three sacred entitlement cows that consume a vast majority of the federal budget (and I use the term budget generously), let's truly spread the pain around and raise taxes on everyone, including the nearly 50 percent of Americans who pay zero federal income taxes. Those Americans need to have some skin in the game, too. I recommend at least a 5 percent federal income tax bracket for them. The insane free ride needs to end. [...]
Let's also stop the insanity by suspending the right to vote of any American who is on welfare. Once they get off welfare and are self-sustaining, they get their right to vote restored. No American on welfare should have the right to vote for tax increases on those Americans who are working and paying taxes to support them. That's insane. [...]
It shouldn't take a Motown guitar slayer to come up with these common-sense bargaining chips before taxes are raised on the producers, which will further choke the economy. How about it, GOP?
Major newspapers in Pennsylvania, Oklahoma, and Nevada have urged their governors to reject expansion of Medicaid -- the shared state-federal program that provides health care coverage to low income Americans -- under the Affordable Care Act, citing high costs that they claim would add to the states' financial burdens. In fact, a new report by the Kaiser Family Foundation finds that the Medicaid expansion would substantially reduce the number of uninsured at little cost to their state budgets.
As governors continue to decide whether to implement key aspects of the Affordable Care Act, the editorial boards of the Pittsburgh Tribune-Review and the Las Vegas Review-Journal urged the rejection of Medicaid expansion, while the editorial board of The Oklahoman applauded the recent decision by Republican Gov. Mary Fallin to reject the funding.
From the Pittsburgh Tribune-Review:
As stipulated under the Patient Protection and Affordable Care Act, Medicaid eligibility will expand to an additional 800,000 Pennsylvanians -- in effect, placing a quarter of the state's residents on government insurance, according to the Commonwealth Foundation. Never mind that Medicaid currently consumes 30 percent of the state's operating budget.
Once fully realized, ObamaCare will have all the appeal of a perpetual flu.
From the Las Vegas-Review Journal:
The accompanying Medicaid expansion, meanwhile, would throw millions of additional Americans into a system that's already bankrupting state governments and increasing costs in the private market. Geoffrey Lawrence of the Nevada Policy Research Institute, noting last week that Gov. Sandoval is pondering whether to expand Medicaid eligibility in Nevada, said any Medicaid expansion would mean reduced access to care for those currently enrolled.
President Obama won re-election this month, but the states hold the future of ObamaCare in their hands. Knowing the harm the law would do to our citizens, the economy, and the quality of American health care, Gov. Sandoval should join with many of his colleagues and decline to become the enabler of a vastly expensive, European-style medical rationing system that poll after poll has shown most Americans do not want.
From The Oklahoman:
Oklahoma has joined a growing list of states that won't expand Medicaid or implement state-run health exchanges, two key components of Obamacare. Predictably, the political left argues Republicans are being obstructionist. But why would state Republicans rush to implement a bad law to benefit a president who's made clear he would never do the same if the tables were turned?
As of June 2011, Medicaid programs in all 50 states and the District of Columbia provided health care coverage to 52.6 million people. However, as the economy has improved, the rate of growth of enrollment in the program has slowed down. With the passage of the Affordable Care Act, the federal government wants to expand the program in an effort to decrease the number of uninsured by providing coverage to those with an income below 133 percent of the federal poverty level. Previously, qualification for the program varied depending on factors such as age or employment status. Despite the claims from these editorial boards, the Affordable Care Act's Medicaid expansion provision will in fact achieve its goal, at only a slightly higher cost than what those states currently pay for Medicaid.
A recent study published by the Kaiser Family Foundation found that if all states expanded Medicaid it could lead to health care coverage for an additional 21.3 million people nationally with a total cost of around $1 trillion. Yet, the combined costs to states would only be approximately $76 billion as the federal government will cover the other $952 billion.
Specifically, Pennsylvania, Nevada, and Oklahoma would see significant increases in the number of people insured for only small changes to their current spending.
In Pennsylvania, if all states expanded Medicaid, the state would see a 52 percent reduction in uninsured citizens, while spending 1.4 percent more on Medicaid than current expenditures when accounting for the savings in uncompensated care. While Pennsylvania's expansion costs are higher than some other states, healthcare professionals note that this is because Pennsylvania currently has one of the more draconian Medicaid systems in the country. From WHYY in Pennsylvania:
New Jersey is on the opposite end of the spectrum, with projected costs of $1.2 billion with an expansion. And Pennsylvania? Almost $2 billion over 10 years, even after accounting for savings.
"Pennsylvania has not expanded to adults whereas other states have," said Ann Bacharach with the Pennsylvania Health Law Project.
"If you're a single, childless adult, there is not much that the state can offer in terms of coverage," Bacharach said.
So the new enrollees covered by an expansion would add costs, but the federal contribution would not provide the same savings in Pennsylvania as it will in Delaware.
Meanwhile, Nevada would see a 44.8 percent reduction in uninsured citizens for only 2.6 percent more in Medicaid spending if all states expanded Medicaid coverage. As Media Matters has previously noted, the Review-Journal's editorial board has attacked the Medicaid provision of the Affordable Care Act while neglecting to note any of the benefits expanding Medicaid would have on their state.
Lastly, Oklahoma would see a 54.4 percent reduction in uninsured for only 1.9 percent more in Medicaid spending if all states expanded Medicaid coverage. From Tulsa World:
[David Blatt, director of the Oklahoma Policy Institute] said the governor's calculations also leave out savings to the state in areas such as health, mental health and corrections that are currently outside the Medicaid system but could be included with expansion. Savings to those agencies has been estimated at more than $49.4 million a year.
Also missing from the calculation would be tax revenue increases the state would see as a result of the Affordable Care Act, he said.
For example, the state has a small tax on insurance premiums. If thousands of Oklahomans begin purchasing insurance through a federal health insurance exchange, that tax revenue goes up, he said.
If every state adopted the Medicaid expansion provision they would receive $9 in federal money for every $1 they spend to expand the program. As John Holahan, head of the Urban Institute's Health Policy Research Center and the study's author, said, "It's hard to conclude anything other than this is pretty attractive and should be pretty hard for states to walk away from." Unfortunately, the editorial boards of the Tribune-Review, Review-Journal, and The Oklahoman failed to provide that perspective and explain the overall benefit of Medicaid expansion to their readers.
Fox News and conservative blogs are hyping a dishonest chart that shows employment decreasing while the numbers of people receiving government aid increasing since the end of 2008. However, an honest look at these figures would show that employment is on an upswing and enrollment in government aid programs has been increasing for decades.
The Weekly Standard and Fox Nation both put the chart, which is sourced to Republican Senator Jeff Sessions, on their websites. And Fox News aired the chart as well. The Standard said that the chart "details the alarming fact that enrollment in federal social welfare programs like Food Stamps, Medicaid, and Disability have far outpaced job growth over the last four years."
But this chart is incredibly dishonest. The chart uses December 2008 as its starting point, a date in the middle of a very deep recession. Employment began decreasing at the beginning of 2008 soon after the U.S. economy went into recession and was still decreasing in December 2008. But jobs have been increasing since in early 2010, resulting in the addition of more than 4 million jobs:
Furthermore, the increase in people receiving Social Security Disability benefits is not new. The number has been surging since the 1990s:
A New York Times article on Mitt Romney embracing the health care reform he passed in Massachusetts hid the fact that Romney has promised to repeal President Obama's Affordable Care Act.
The Times reported that Romney recently "talked about the health care law he championed as governor of Massachusetts" and quoted Romney saying: "I got everybody in my state insured. ... One hundred percent of the kids in our state had health insurance."
But the Times left out the most important fact on this controversial campaign issue: If he becomes president, Romney plans to undo the law that will provide insurance to all Americans. He has proposed repealing President Obama's Affordable Care Act, which requires that all Americans have health insurance and has even pledged to gut the Affordable Care Act on his first day in office by granting waivers from the law to all 50 states.
Furthermore, Romney's plans for Medicaid would leave many Americans in worse shape than they were before passage of the Affordable Care Act. Romney plans to change Medicaid from a federal program to a system in which the federal government gives a fixed amount of money to each state. According to Bloomberg News, this plan would cut Medicaid by $1.26 trillion over nine years.
As the American College of Physicians has noted, the Congressional Budget Office analyzed a similar plan issued by Romney's running mate and predicted that it could require states to make "considerable cutbacks" in Medicaid. CBO stated that such cutbacks might involve reduced eligibility, reduced "coverage of fewer services, lower payments to providers, or increased cost-sharing by beneficiaries -- all of which would reduce access to care."
In contrast with the Times, The Washington Post, the Associated Press, and The Los Angeles Times all reported that Romney boasted about his health reform in Massachusetts while simultaneously opposing the federal Affordable Care Act.
Right-wing media figures are heaping praise on Rep. Paul Ryan's (R-WI) budget plan, with one Fox host calling Ryan "Mr. Budget." In fact, Ryan's budget plan would harm many Americans: It increases taxes on the poor while cutting them for the wealthy, drastically cuts Medicaid and other needed safety net programs, and would cost millions of jobs by reducing federal spending during a still-weak economy.
The New Hampshire Union Leader's editorial board attacked the new Medicaid expansion provisions in the Affordable Care Act and instead proposed a block granting scheme, but experts say block granting Medicaid would be detrimental to the most vulnerable Americans and decrease the quality of health care.
The Congressional Budget Office's annual long-term budget report shows that without any changes in the law, government debt will peak this year, then slowly decline for two decades. Despite this finding, many media outlets are emphasizing a "dire" outlook, while downplaying or ignoring CBO's finding that there is a path to a stable budget that includes maintaining the social safety net.
From the May 8 edition of Fox News' Fox & Friends:
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From the March 26 edition of Fox News' Fox & Friends:
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From the March 20 edition of Fox News' Fox & Friends:
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From the August 15 edition of Fox Business' Lou Dobbs Tonight:
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