{"id":37673,"date":"2017-03-13T04:00:03","date_gmt":"2017-03-13T08:00:03","guid":{"rendered":"http:\/\/quotulatiousness.ca\/blog\/?p=37673"},"modified":"2017-03-12T12:35:42","modified_gmt":"2017-03-12T16:35:42","slug":"its-not-really-a-debate-over-obamacare-its-a-debate-over-medicaid","status":"publish","type":"post","link":"https:\/\/quotulatiousness.ca\/blog\/2017\/03\/13\/its-not-really-a-debate-over-obamacare-its-a-debate-over-medicaid\/","title":{"rendered":"“It\u2019s not really a debate over Obamacare, it\u2019s a debate over Medicaid”"},"content":{"rendered":"

Robert Tracinski<\/a> explains why the Republicans are having such a hard time with their oft-promised “repeal” of Obamacare:<\/p>\n

House Republicans have released their proposed measure to \u201crepeal and replace\u201d Obamacare, and the whole enterprise is already losing steam right out of the gate. The measure is too small and incremental, less a repeal of Obamacare and more of a repair of it, keeping numerous basic features intact.<\/p>\n

If you want to know why Republicans have bogged down, notice one peculiar thing about the Obamacare debate so far. It\u2019s not really a debate over Obamacare, it\u2019s a debate over Medicaid. That\u2019s because Obamacare mostly turned out to be a big expansion of Medicaid. The health insurance exchanges that were supposed to provide affordable private health insurance (under a government aegis) never really delivered. They were launched in a state of chaos and incompetence, and ended up mostly offering plans that are expensive yet still have high deductibles. Rather than massively expanding the number of people with private insurance, a lot of the effect of Obamacare was to wreck people\u2019s existing health care plans and push them into new exchange plans.<\/p>\n

Ah, but what about all those people the Democrats are claiming were newly covered under Obamacare? A lot of them \u2014 up to two-thirds, by some estimates \u2014 are people who were made newly eligible for a government health-care entitlement, Medicaid. But shoving people onto Medicaid is not exactly a great achievement, since it is widely acknowledged to be a lousy program.<\/p>\n

Conservative health care wonk Avik Roy explains why: \u201c[T]he program\u2019s dysfunctional 1965 design makes it impossible for states to manage their Medicaid budgets without ratcheting down what they pay doctors to care for Medicaid enrollees. That, in turn, has led many doctors to stop accepting Medicaid patients, such that Medicaid enrollees don\u2019t get the care they need.\u201d Partly as a result, a test in Oregon found no difference in health outcomes between those with access to Medicaid and those without.<\/p><\/blockquote>\n","protected":false},"excerpt":{"rendered":"

Robert Tracinski explains why the Republicans are having such a hard time with their oft-promised “repeal” of Obamacare: House Republicans have released their proposed measure to \u201crepeal and replace\u201d Obamacare, and the whole enterprise is already losing steam right out of the gate. The measure is too small and incremental, less a repeal of Obamacare […]<\/p>\n","protected":false},"author":1,"featured_media":35193,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[84,66,53,13],"tags":[698,121,937,517],"class_list":["post-37673","post","type-post","status-publish","format-standard","hentry","category-government","category-health-science","category-politics","category-usa","tag-congress","tag-insurance","tag-obamacare","tag-republican"],"jetpack_featured_media_url":"https:\/\/quotulatiousness.ca\/blog\/wp-content\/uploads\/2016\/06\/favicon.png","jetpack_shortlink":"https:\/\/wp.me\/p2hpV6-9ND","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/posts\/37673","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/comments?post=37673"}],"version-history":[{"count":1,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/posts\/37673\/revisions"}],"predecessor-version":[{"id":37674,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/posts\/37673\/revisions\/37674"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/media\/35193"}],"wp:attachment":[{"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/media?parent=37673"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/categories?post=37673"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/tags?post=37673"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}