Medicaid has become a "national disgrace" that now is little more than a "middle-class entitlement for nursing homes",
the Wall Street Journal contends in an editorial.
But despite all the system's failings, Democrats still want to expand the program.
"The truth is that liberals view Medicaid as a national model, not a national disgrace," the editorial says.
More than 20 percent of Americans already have coverage under Medicaid, the state-federal program designed to provide medical care for the poor. "And that's before Obamacare dumps up to 20 million new dependents onto its rolls," Journal editors write.
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Liberals are getting bent out of shape, because 26 states have rejected Obamacare's Medicaid expansion,
the editorial says.
But the Supreme Court ruled 7 to 2 last year that Obamacare couldn't require states to expand Medicaid. It decided that Obamacare's vision of Medicaid would turn it into a program that is no longer about caring for the poor.
"The major reason states don't want to participate is that rather than help members of society emerge from poverty, new Medicaid is supposed to be a permanent Washington-run, price-controlled health system, with no flexibility for the states," the editorial says.
The federal government offers to pay for all the costs of Medicaid expansion over the next three years. But the editorial says governors have reason to be concerned about Medicaid costs that are predicted to rise 13 percent in 2014 under Obamacare.
"The Beltway boys and their allies in the hospital industry that are ravenous for more federal revenue are stunned that their bribery failed. So the new line of assault is to declare that the 26 conscientious objector states must hate poor people," the editorial says.
"In reality, Medicaid is now mostly a middle-class entitlement for nursing homes. Almost two-thirds of Medicaid spending flows to the elderly, and 60 percent of people in long-term care institutions are on the program."
Among people under 65 who are eligible for the program now, 20 percent haven't even signed up, the editorial says. "One reason might be the scandalously poor quality of care as states squeeze down provider reimbursements."
If Medicaid expansion advocates want to help the poor, they should work on fixing Medicaid's problems, the editorial says. Prioritizing spending and giving governors waivers to manage case loads and increase efficiency would be a good start, it suggests.
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"Coverage on Obamacare's nominally private exchanges largely clones Medicaid's narrow networks of doctors and hospitals, low reimbursements, limited patient choice and heavy federal regulation," the editorial states. "It might be more accurate to call it Obamacaid."
This all indicates that Democrats' true focus is on next year's elections, the editorial says. "They'll run against Republicans as ideologues who won't even accept free money from Washington, and who, by the way are mean-spirited and cruel."
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