The only people who benefit from House Republican axe to Medicaid are those with insurance and without hearts

The Kaiser Foundation and Urban Institute today released their analysis of what happens if the Republic House budget is passed, and it’s real bad: 44 million more Americans will lose Medicaid health insurance coverage.

Who could possibly benefit from 44 million poor and indigent people suddenly not having protection against illness and medical bills?

Let’s start by taking a look at who doesn’t benefit:  first and foremost, the 44 million  who are now getting a modicum of health care protection and will suddenly be without any.  The saddest part is that even though the people on Medicaid are virtually all poor, they are still allowed to vote, and yet many don’t.

But groups other than the indigent losing coverage also suffer.

For example, health insurance companies will suffer, because they serve as administrators and claims processors for state Medicaid programs, a fact that those who tout privatization conveniently never mention.  The Medicaid insurance carriers will have fewer Medicaid customers, and only a fool would think that all or even a majority of people who are kicked off Medicaid rolls will buy private insurance.

Those physicians who still treat Medicaid patients will find their practices shrink.

Hospitals who accept indigent patients will find their beds filled with nonpayers, and these nonpayers will be far sicker than they would have been if they had been on Medicaid, because all pertinent surveys demonstrate that people without insurance forgo preventive care and wait to go to the doctor until an illness or condition is truly critical. 

Then there are the people who can afford insurance who have compassion towards their fellow men.  After all, 44 million men, women and children will now not be able to afford to go to the doctor or to get a prescription filled.  Many of these people will suffer excruciating pain, miss work or be unable to work and die younger than they have to die.   It’s true that those with insurance may pay less in taxes, but only the truly wealthy are getting a significant tax break, say those making more than $150,000 or $200,000 a year or those with at least a few million in investments.

(Remember that we currently have historically low income taxes for many, but especially for the wealthy.  I think I was the one of the first to point out this embarrassing fact, and also to recognize that massive budget cuts are what are paying almost dollar for dollar for the continuation of the temporary Bush II tax cuts.  But I’m delighted that many others are picking up the beat, including Michael Tomasky in his fine article titled “The Budget battles on Which His Reelection Depends” in the latest issue of the New York Review of Books.)

Thus, virtually the only people to benefit are those whom the government is already subsidizing with historically low tax rates.  Those in the middle class are getting a minor subsidy, but the wealthier you are the greater the subsidy for two reasons: 1) you make more; and 2) the more money you make, the greater the difference in the rate you once paid and now pay.

But is the tax break enough money at any level to enable someone to feel good about themselves and their community knowing that 44 million more people are going without health care?

My conclusion: the only people to benefit from the Republican House proposal to cut Medicaid funding by one-third over the next 10 years are those who:

  • Have health insurance
  • Are enjoying the low tax regime of the last 30 years
  • Are pitiless and heartless Scrooges.

We’re a nation of Church, Mosque, Synagogue, Meeting and Hindu-Temple-goers, so I can’t imagine many people who will fit all three criteria.

But evidently those who do meet these criteria dominate the voters, and seem to dominate the small group of individuals and foundations feeding Republican and Democratic politicians a steady stream of cash.


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