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"Compassion:" Obamacare's Medicaid Expansion Failing Patients in California

The way the Left tells it, conservatives tend to oppose President Obama's policies out of a nihilistic elixir of reflexive,  racially-motivated spite, and callous indifference toward -- if not active support of -- poor people dying.  The former smear isn't supported by empirical evidence, while the latter is almost laughably uncharitable.  The truth is that the vast majority of conservatives oppose big government projects because they believe those policies don't work, are detrimental to the country, and in some cases, even harm the very people they're intended to help.  Obamacare's expansion of Medicaid is a case in point.  On the surface, this initiative sounds attractive to average, conscientious people: We're expanding health coverage for less fortunate people.  That's a good thing.  That's compassionate.  This line of argument polls pretty well.  But intentions are not the same as outcomes, and "coverage" does not equal "care." In reality, the policy of Medicaid expansion piles more patients into an already-strained and underfunded system that is a demonstrable failure -- and an insanely expensive one, at that.  Medicaid does not improve health outcomes for its beneficiaries, as compared to uninsured people.  We highlighted a Los Angeles Times article last month that contextualized the health and fiscal problems California is facing with its MediCal expansion. The only "success" described below is the staggering number of Californians who've been hooked into government dependency:

The mountain of medical bills threatens to undermine Gov. Jerry Brown's efforts to strengthen state finances — his central promise of the past four years. Enrollment in the state's healthcare program for the poor, known as Medi-Cal, has exploded by 50% since President Obama's signature law took effect. Although the federal government picks up most of the tab, state costs have also been growing, and faster than expected...Over the next year, total Medi-Cal enrollment is expected to reach 12.2 million, he said — about one-third of the state's population. It was less than 8 million in 2013. Even though costs are increasing, advocates for the poor say the state has not allocated enough money to provide healthcare to those who are still struggling years after the recession. Payments for Medi-Cal services were reduced during years of budget crises, making doctors more reluctant to participate in the program.

It is not compassionate to vastly expand a program that was largely failing the people who were already relying on it.  It's not compassionate to stick hard-working taxpayers with an ever-higher tab to fund a program that isn't working.  It's not compassionate to pretend that federal dollars grow on trees, or that phased-in state-level funding won't impact budgets and other spending priorities.  It's not compassionate to make access to care harder to attain for the indigent.  The
Contra Costa Times shines a brighter light onto the issue this week, profiling average Golden State residents who are being betrayed by Obamacare's promises:

Julie Moreno felt lucky to be among more than 2.7 million previously uninsured Californians to be added to Medi-Cal, the state's health care program for the poor. Until she needed cataract surgery. For three months after her November 2013 diagnosis, the 49-year-old Mountain View resident said, she tried to get an appointment, but each time she called, no slots were available. Desperate and worried, she finally borrowed $14,000 from her boyfriend's mother to have the procedure done elsewhere last February. One year into the explosive, health law-induced growth of Medi-Cal, it appears one of the most alarming predictions of critics is coming true: The supply of doctors hasn't kept up with demand. One recent study suggests the number of primary care doctors in California per Medi-Cal patient is woefully below federal guidelines...In fact, seven months after Moreno's surgery, her original surgeon's office called just to say they still couldn't fit her in.

Nothing to see here, coo obtuse and/or deceitful state officials:

Those officials continue to insist that the current delays to see a doctor and crowded emergency rooms are all part of to-be-expected growing pains. But many experts say the problems are so widespread they shouldn't be ignored. "California did a good job of getting people signed up, but they basically stuck their heads in the sand and assumed that California physicians would just jump right on board and want to take more Medi-Cal patients," said Dr. Del Morris...Morris and other experts say the situation is about to get worse, in part because of Medi-Cal's health care reimbursement rates. For years, the rates paid by Medi-Cal -- called Medicaid in the rest of the country -- have been among the nation's lowest. A provision of Obamacare hiked the rates for primary care doctors to the substantially higher Medicare rates for two years, but those increases ended on Dec. 31. A second blow came last month when the state cut the Medi-Cal reimbursement rate by another 10 percent, a reduction approved by California lawmakers in 2011 but delayed in a court battle that doctors ultimately lost...Even before the latest cuts, Medi-Cal doctors -- particularly specialists -- in California's rural areas often seemed nearly impossible to find. And the shortage of Medi-Cal physicians appears to be causing spikes in the number of Medi-Cal patients being treated in hospital emergency rooms around the state.

ER visits, or "uncompensated care" in wonk speak, were supposed to drop because of Medicaid expansion.  The exact opposite is happening, and California's experience is the rule, not the exception.  "Compassion" and happy intentions do not translate into successful policies.  Democrats in Washington and Sacramento have fashioned an ideological scheme that is ripping off taxpayers and hurting poor people in need of care, not "coverage."  Incredibly, the Obama administration says one of its top healthcare priorities is to coax more states into adopting this wheezing scheme.  This mentality suggests either willful blindness to data-driven outcomes, or an ideological commitment to enlarging government that runs so deep that charts like this look like good news:

If spending more = "helping," and enrolling people into government programs = "compassion," this is a roaring success. I'll leave you with a half-joking question: Is California's creaky, burdened healthcare system prepared to deal with the fallout of, um, measles parties?  

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