Medicaid

Colorado Gov. John Hickenlooper signed Senate Bill 200 on Monday, and with that, an estimated 189,000 more Coloradans will be eligible for Medicaid. Enacting that expansion of government health care was the right thing to do on a number of levels.

Not that critics of Obamacare would agree. The expansion of government health care SB 200 allows for is a critical component of the president’s health-care reform, and, as with anything connected to it, his political opponents tried to block it. The Legislature passed SB 200 with exactly one Republican vote.

But regardless of how one thinks of Obamacare, it is the law, it is being implemented and, U.S. House votes notwithstanding, its foes do not have the means to undo it. What needs to happen now is to see how it works in practice and make adjustments as needed. And, yes, at some point that could possibly include starting over.

Trying to block it piecemeal, however, is all but guaranteed to make matters worse. That might be acceptable to some of the president’s foes (or perhaps even their intention) but it is not good governance and not in the best interests of the country or the state.

What is good for Coloradans is an honest accounting of health-care costs. There was an incident during last year’s presidential campaign in which spectators at one of the debates called out in favor of letting patients die if they cannot pay for medical care. But this is a compassionate country, and few Americans would agree. So, as the law and medical ethics require, when sick or injured people show up at an emergency room they are treated. The cost of that treatment, however, can show up as higher health-care costs overall. And that burdens individuals, businesses and institutions across society.

By expanding Medicaid coverage to people making up to 133 percent of the federal poverty level, SB 200 lets Colorado take advantage of federal funding, which will cover the full cost for the first three years. After that it will decrease to 90 percent by 2020, with an existing tax on hospitals taking care of the state’s 10 percent. As Hickenlooper took care to point out, none of the state’s general-fund tax money will be used.

Federal money is not free, of course. It is the taxpayers’ money. But we taxpayers are also paying for indigent care now, indirectly through emergency rooms. The difference is a more honest accounting – and quite possibly lower costs.

State Sen. Ellen Roberts, R-Durango, objected to SB 200 citing a shortage of physicians and her thinking that Colorado has not done enough to stop Medicaid fraud. Both are legitimate questions, but neither is a problem caused by SB 200. Although there seems to be little evidence suggesting Medicaid fraud is widespread, what there is should be prosecuted. Likewise, a shortage of doctors should be addressed. Both should be done with or without Obamacare.

Few problems will be fixed, however, in the climate of today’s politics. As with so much of health care, there is plenty to debate here. But the object should be to improve legislation, not to score political points on national policy.

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