Medicaid expansion will be at the expense of seniors, veterans
Alaska Older Veterans Report
Much has been written about the governor’s attempt to expand Medicaid in Alaska and the debate has yet to be settled. While I am sure some of the stakeholders like the working poor, social service non-profits, medical providers, and small businesses are in support of the expansion, seniors and veterans are the big losers.
I have been admonished that it is selfish of me to deny coverage to someone who cannot afford health insurance when I have coverage. This line of justification does not wash with me. Seniors my age have paid into Medicare since its inception and still continue to pay. Veterans have earned their coverage through service to the country. These are real entitlements the country owes our group.
Just to be clear; single payer will lead to a single provider like the VA for all. Is that what you want?
By what short-sighted reasoning can you justify denying coverage to seniors and veterans to cover able-bodied people with coverage that has no deductible and co-pay? Why should ex-cons and the self-employed get better coverage than veterans and the elderly? I would love to hear someone defend that stance.
While it may be refreshing to have an elected official follow through on a campaign promise, this is not the hill to die on, Governor Walker. All this expansion will be at the expense of Medicare patients. Medicaid covers more treatments than does Tricare, VA and Medicare. Providers have to pay their staff and bills. They will pick a new Medicaid client over a Medicare client because the remuneration is better and faster. Is that fair? I do not think so.
The specious reasoning that the expansion will create new jobs is a joke. The loss of 4,000 troops at JBER was treated by the press and local politicians as “no big deal.” However, the new 4,000 job estimated creation has been heralded as the answer to the loss of oil revenue.
Much of the debate has been centered around the cost after the free Fed funding period has ended. Since management of downstream costs has never been the state’s strong suit, I am going to pass on all but one comment. The earnings of the Permanent Fund will have to be used as stated in the Alaska Constitution, Article 15, Section 1, which was passed by a vote of the people in November 1994. Not enough people are working and earning incomes for the state to close the gap by imposing an income tax. A call for a statewide sales tax will be met with an endless string of exemptions for the poor and the well-connected that would render it just another tax on the productive segment of the state.
Believe it or not, Alaska does need someone working in the private sector, not in government or on the relief roles. If we could afford to fund everything, then I might be for an expansion. However, seniors should not be fooled by those who say it is federal money. All taxes come from somewhere eventually. How long the central bank can prop up this global fiat money Ponzi scheme is anyone’s guess.
The state is worried about its bond rating when it should not be bonding anything until our revenue stream is stable. Is three to four years too long to wait to let the global oil market settle down?
I am not an anarchist, but I do believe in limited government. Alaska has always had a disconnect when its comes to state finances. It has been a good run and maybe in a few years, the throughput of TAPS and Henry Hub pricing will return us the glory days. However, in the meantime, just remember in the 2002 gubernatorial race when Fran Ulmer wanted a state income tax because there was no other way to fund the state government. Somehow we made it this far in recent history without a state income tax and should tell the Wall Street bandits to buzz off.
The best justification by the proponents of expansion is the Fed will pay for the cost in the first three years. Even in that first three years additional state staff will be needed. After that short period, the state starts picking up the cost with no legal exit plan. All expansion will do is add to the list of “contractual obligations” that has to be satisfied first before any other money is allocated. Like every other state and local taxing entity, Alaska has a mountain of uncontrollable, unfunded liabilities in our PERS and TERS program.
If we in Alaska do not change our ways, we will become General Motors. GM found themselves in the position of being a pension and health insurance plan with a car company attached to it.
If you look at the global financial market, you see dark clouds forming. Greece is a just pimple on the backside of the EU compared to China and Puerto Rico. Yes, Puerto Rico, that little U.S. possession, has found itself over $70 billion in bond debt to the U.S. bond market. Yes, the same Wall Streeters that gave us mortgage-backed securities in 2008 is telling Alaska how they expect to be bailed out.
Instead of expanding Medicaid, we should reduce the coverage to the lowest level possible by law. That move would at least put Medicaid clients on par with Medicare clients.
Finally, I would like to see the retired state workers go on Medicare at age 65 retroactively and buy their Part B, like many seniors are forced to do. That would likely put an end to this expansion nonsense.
What I am now waiting for is the state to discover Pension Obligation Bonds. I cannot wait to hear the pitch about this new way to fund an overspent government by using future pension payments as collateral. Appling for more credit cards is always more fun than paying the cards off you already have.
Mike Dryden is a retired Army Major and current board member of Older Persons Action Group, Inc.