The true cost of Medicaid expansion?

Taxpayers, gird your loins! Your burdens jumped on Jan. 1, the first day of Medicaid eligibility for a new population — childless adults who aren’t disabled and whose incomes are between 100 and 133 percent of the federal poverty level.

An estimated 70,000 to 100,000 Montanans will sign up in this grandest augmentation of welfare services in recent history, if not in Montana’s entire history. But over half of the states in which Medicaid was expanded have seen enrollment numbers exceed projections. (About 125,000 Montanans were already on Medicaid.)

Who pays? If you make enough to owe federal income taxes, you will, as Obamacare stipulates that federal funds cover the first two years of the expansion. Of course, the federal government doesn’t actually have the money, borrowing a significant chunk of what it doles out. So if you’re a teenager or a child, your future taxes just increased to pay for this present borrowing that’ll put tens of thousands more Montanans on Medicaid.

Who benefits? Studies show minimal-to-nil health benefits to Medicaid-expansion recipients. Prior to Obamacare’s Medicaid expansion, low-income people accessed less care or stiffed doctors and hospitals (the phenomenon known as “uncompensated care”) while providers charged other patients more to make up the losses. Now, hospitals and doctors can bill Medicaid and get payment — from the Treasury and its borrowings. Insurance ratepayers should benefit (we’ll see!), but providers will benefit the most. And the needle of the health-o-meter of the poor will barely budge.

Thoreau’s words from “Civil Disobedience” resound: “This government never of itself furthered any enterprise, but by the alacrity with which it got out of its way.”

Meanwhile, for taxpayers, it’s drip, drip, drip. —Tom Burnett, Bozeman Republican, House District 67