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Analysis: Christie Gets It Wrong on Obamacare's Medicaid Expansion

As I've written in the past, Gov. Chris Christie's policies are a mixed bag for conservatives. When Christie performs well, I'm happy to praise him. When he's getting railroaded by a sloppy and biased media, I'll do what I can to set the record straight. And when he gets it wrong in my view, I'll say so. This is one of those instances. At a town hall meeting in Toms River, New Jersey this week, Christie was asked about Obamacare by a concerned citizen:


The constituent asked, "what do we do?" about a law that's hurting people and chasing doctors from the profession. Christie began his answer by stating the obvious, much to the crowd's delight: You elect a new president. He then proceeded to hit the president for being "dead wrong" about his signature law. He hit Obama for cutting Medicare in order to partially fund Obamacare, ripped the steady stream of "unilateral" changes and delays ("because he knows it's not working"), and opined that Washington needs to "start over" on healthcare reform. So far, so good. But Christie hit a false note in defending his temporary and conditional decision to accede to the law's vast expansion of Medicaid in New Jersey:

"So, you know what we’re doing in New Jersey is trying to blunt the impact of this as much as we possibly can. But also trying to help folks who are really in need so we expanded Medicaid here because we believe that folks are better off going to see physicians and having care than going to emergency rooms all the time. We think that’s better. It’s more efficient and they get better care. But the rest of this program does not make any sense and you see people around the country more and more saying that they don’t want it."

This assertion parrots a liberal talking point that isn't supported by the facts. Myth, busted -- by a gold-plated academic study co-authored by an Obamacare architect, no less:

The best evidence has never really supported the hope that the law would reduce emergency room usage. That’s because much of the law’s expanded coverage comes via Medicaid, the jointly run federal-state program for the low income and disabled. And Medicaid beneficiaries tend to visit the emergency room more often than the uninsured. A new study of Medicaid beneficiaries in Oregon makes a strong version of this case. The study, published today in the journal Science, finds that adult Medicaid beneficiaries rely on emergency rooms about 40 percent more than similar uninsured adults. "When you cover the uninsured, emergency room use goes up by a large magnitude," said Amy Finkelstein, a health economist at the Massachusetts Institute of Technology who served as a lead investigator on the study, in an MIT press statement accompanying the study. There were no exceptions to the trend. "In no case were we able to find any subpopulations, or type of conditions, for which Medicaid caused a significant decrease in emergency department use," said Finkelstein.

Medicaid expansion significantly increases expensive emergency room treatment, with no exceptions, so that excuse doesn't fly. What about Christie's assurance that Medicaid insures "better" and "more efficient" care? That's also a fatally flawed claim. According to the same Oregon study, which is the definitive analysis of the program, Medicaid recipients do not experience better health outcomes than their uninsured counterparts. In other words, Medicaid is horribly broken -- and rather than fixing it, Obamacare recklessly expands its ranks by millions:

For three years, an incredibly nerdy—but consequential—debate has raged among health policy researchers regarding Medicaid, America’s government-run health-care program for the poor. Piles of studies have shown that people on Medicaid have health outcomes that are no better, and often worse, than those with no insurance at all. But supporters of Obamacare were cheered in 2011 when a lone study, out of Oregon, purported to show that Medicaid was better than being uninsured. Yesterday, however, the authors of the Oregon study published their updated, two-year results, finding that Medicaid “generated no significant improvement in measured physical health outcomes.” The result calls into question the $450 billion a year we spend on Medicaid, and the fact that Obamacare throws 11 million more Americans into this broken program.

Healthcare policy expert Avik Roy wonked out over the reasons why the Oregon study was even more devastating to knee-jerk statists than even the damning top line result indicates. Read the whole thing. Chris Christie isn't the only Republican governor who caved to pressure and embraced this element of Obamacare. He's entitled to pursue the policies that he thinks are best for the people of New Jersey, but he does his constituents and himself a disservice by defending his actions with lazy, plausible-sounding conventional wisdom rather than the facts.

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