In Florida last week, for example, Carol Gentry, editor of the site Health News Florida, got ahold of emails showing that costs cited Gov. Rick Scott had been refuted by the state’s chief economist—and that Scott was aware of the pushback but had continued using the inflated numbers anyway. The higher estimates had been produced by a Scott advisor who apparently assumed that the federal government simply would not provide the boost in funding promised under the ACA.
The Tampa Bay Times’s PolitiFact Florida quickly jumped in to declare Scott’s number’s “False,” and the story soon became statewide news, with papers like the Sun-Sentinel editorializing on Scott’s “fuzzy math.” Within days of Gentry’s report, Scott’s office had released a far lower estimate of state costs that reflects the federal contribution; Aaron Deslatte of the Orlando Sentinel has a comprehensive write-up here. Florida may yet reject the Medicaid expansion, but there’s now a better chance that the upcoming debate in the state legislature will be grounded in fact.
— A similar debate is playing out in Ohio, and while it doesn’t share the sexy (well, sexy for wonk news) smoking-gun angle of disregarded emails, The Plain Dealer of Cleveland has been keeping track of it. With Gov. John Kasich preparing his own announcement on Medicaid, the PD’s Sarah Jane Tribble took a thorough look at a think tank report released Tuesday that projected a program expansion would actually produce a net gain for Ohio’s state budget over the next nine years. (The article was prominently featured on Cleveland.com Wednesday morning, which was nice to see.)
That study was big news in part because the Kasich administration had previously produced hair-raising estimates of Ohio’s Medicaid costs in coming years. Those forecasts centered around a different population—people who are eligible for Medicaid but not yet enrolled—for whom the federal government will pick up a lower share of the cost. There are likely to be real costs for Ohio there once the ACA’s individual mandate prompts some of those people to sign up for Medicaid, and unlike any expenses associated with expanded eligibility, they aren’t optional for the state. But as an excellent article by The Plain Dealer’s Kate Irby noted last October, Ohio’s projections for those expenses are far above those of neighboring states. That matters because high projected costs to the state for either set of Medicaid patients, whether well-founded for not, offer a reason not to expand the program—or, for that matter, to commit state resources to other projects.
Kasich and his team have been measured in their recent comments, and it’s not clear which way the debate will go. Whatever happens, The Plain Dealer has laid a solid foundation for future coverage.
— The expansion of Medicaid in Georgia is not an especially interesting question—the state looks like a firm no, and The Atlanta Journal-Constitution has been focusing with good reason on a separate, high-profile debate over how to fund the state’s existing program.
Still, a recent item by The New Republic’s Jonathan Cohn that focused on one state lawmaker’s views about Medicaid expansion is a model for writing about how misinformation clouds public discussion of the issue.
Cohn, a liberal who favors expanded healthcare coverage, listened to Sharon Cooper, a Republican state legislator from the Atlanta suburbs, make her case against the expansion—and then he checked out what she said:
But one of her arguments caught my attention, because in more than a decade of covering health policy I’d never heard it before.
The claim was that people on Medicaid sue their doctors more than people who have private insurance. To check its veracity, I consulted Sara Rosenbaum, a professor at George Washington University and expert on Medicaid. “The opposite is true,” she told me, because poor people have less access to lawyers. If anything, she said, people on Medicaid are less likely to sue. The most comprehensive assessment available, from the U.S. Office of Technology Assessment, backs this up. And while that report dates back to 1992, I could find no more recent analysis. (Nor could I get substantiation from Cooper, despite several requests for comment.)