NTF worksheet: legwatch164.doc. 9-18.

The financial health of taxpaying Nebraskans and our entire state will suffer, if voters approve Medicaid expansion in the November election. Furthermore, the general health of our state population will not improve.

* In Oregon, researchers from MIT found that those enrolled in expanded Medicaid had no significant improvements in measured physical health outcomes.
* U. of Virginia researchers found that in almost 900,000 surgeries performed during 4 years, Medicaid expansion patients were 13% more likely to die after surgery than uninsured patients.
* Medicaid expansion has helped increase our opioid epidemic by making it easier for patients to obtain powerful painkillers courtesy of the bureaucracy. A Senate Homeland Security Comm. report noted drug overdose deaths per 1 million are rising twice as fast in Medicaid expansion states than in other states.
* In states that began Medicaid expansion, the share of spending on K-12 education, public safety, transportation, and infrastructure fell. Tax cuts disappear. (Wayne Hoffman, Idaho Freedom Foundation, Growing Medicaid Program is Already Hurting Schools, Other Programs, July 27, 2018)
* Medicaid expansion will divert funding resources from the truly needy.
* Single, able-bodied adults who earn up to 138%!! of the federal poverty level would qualify.
* Medicaid costs to cover able-bodied adults is almost twice as high as the rate for covering the elderly and disabled.
* States that expanded Medicaid underestimated enrollment by 110% on average (Kaiser Foundation, Urban Institute). Nebraska projected enrollment: not 90,000 but 136,000.
* Revised projected cost for Nebraska: not $3.9 billion but $6 billion. (Foundation for Government Accountability, authors Nic Horton and senior fellow Josh Archambault)
* In Kentucky, Medicaid expansion ran $1.8 billion over budget in FY 2014-2015.
* In 17 states reviewed by the Foundation for Government Accountability, costs surpassed projections by an average of 91%.
* Patients with private insurance will see premium increases because of providers facing low Medicaid reimbursement rates. Some of these patients then will become uninsured. Employer costs will rise along with employee costs. (Former Sen. Jim DeMint, president of the Heritage Foundation)
* Because of low reimbursement rates, fewer doctors will accept additional Medicaid patients.(Former Sen. Jim DeMint, president of the Heritage Foundation)
* In the current political climate, the federal government probably will not keep its commitment for pledged level of support long-term. (Senate Republican Policy Committee “Medicaid Consuming Federal Assistance to States,” June 1, 2015)
* The HHS secretary has discretion to deny NE efforts to repeal Medicaid expanded coverage, if the federal government reneges on its funding. (Thurston Powers, Taxpayers in Every State Bearing Cost of Medicaid Expansion, Dec. 8, 2017, for ALEC)
* In states that expanded Medicaid, promised lower emergency room usage and less charity care from hospitals did not materialize. Expensive emergency room visits increased.
* Several states have levied taxes on private hospitals to help pay for ballooning costs of Medicaid expansion, leading to higher hospital bills for private insurance patients.
* According to Moody’s, “states that will have the largest increases from opting into Medicaid expansion provisions … will experience Medicaid spending growth faster than average with no corresponding uptick in revenues to offset growth.”
* Between 2013 and 2016, total Medicaid spending (state and federal dollars) grew almost twice as fast in states which expanded eligibility compared to those which declined. This growth was not because of increased state spending but from unexpectedly high costs per expansion enrollee. (Josh Archambault, Obamacare’s Medicaid Enrollment Explosion: A Looming Fiscal Nightmare For States)
* Spending and debt will suppress economic growth. (Chris Jacobs, Senior Fellow Pelican Institute, Why Expanding Louisiana’s Program to Able-Bodied Adults Hurts the Economy)
* Enrollees in employer-sponsored or private coverage will switch to expanded Medicaid, placing pressure on private insurance rates. (Chris Jacobs, Senior Fellow Pelican Institute, Why Expanding Louisiana’s Program to Able-Bodied Adults Hurts the Economy)
* Medicaid expansion creates a tax on additional earnings, reducing the incentive to work. (National Bureau of Economic Research)
* Prepare for a reduction in labor supply among those included in such Medicaid expansion. (Naomi Bauman, Illinois Policy Institute, Oct. 21, 2014)

Do the following to help defeat Medicaid expansion at the polls in November:
+ Tell your friends and neighbors why they should vote NO on Medicaid expansion.
+ Photocopy this sheet and distribute it in your neighborhood.
+ Write an editorial to your local newspaper.
+ Call in to a radio talk show.
+ Publicize your opposition to expanded Medicaid on social media like Facebook, Twitter, etc.
+ Make a “Vote No on Medicaid Expansion” sign for your front yard, then hold it up at your polling place.

Research, documentation, and analysis for this issue paper done by Nebraska Taxpayers for Freedom. This material copyrighted by Nebraska Taxpayers for Freedom, with express prior permission granted for its use by other groups in the NE Conservative Coalition Network. 9-18. C.

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