Thursday, January 2, 2014

Another laugher: State officials surprised Feds are shafting them on Medicaid costs

Again this would be amusing if it hadn't been predictable:

Delaware taxpayers appear to be on the hook for millions more in Medicaid spending next year, despite Gov. Jack Markell’s plan to expand access to the program under the Affordable Care Act that was intended to save the state money. 
Officials in Markell’s administration say they were surprised this fall when the federal government signaled it would shift some Medicaid costs back to the state. The move was triggered by a technical change in the way federal economists calculate personal income, and could cost the state an unexpected $25 million.
Some days I give the WNJ's Jonathan Starkey crap, but today he perfectly captures the unintentional irony of Rita Landgraf's comments:
“There’s nothing wrong with what the federal government did,” Landgraf said. “It’s just that it was terribly unfair . . ." 
I'm not sure who really believed that (A) adding 20,000-30,000 people to the 215,000 people in Delaware already on Medicaid wasn't going to cost more; or that (B) the cash-strapped Feds weren't going to look for a way to shift more of the expense downward.  Nobody's repealed the law of gravity recently.

Here's the thing:  the Feds are basically telling Delaware that it will have to pick up about an additional $1,000 per person for the new enrollees.  That, of course, occurs at a time when DEFAC predicts a budget shortfall of about $13 million against baseline spending.  So our next General Assembly will face some interesting choices.  Do we continue to pass out tens of millions of dollars in corporate welfare each year?  Do we continue to bail out casinos?  Do we continue to fund a bloated "homeland security" apparatus that spies on Delaware citizens and otherwise delivers very little in the way of additional security, for--say--the citizens of Wilmington?

Or do we start hearing from our Senators and Representatives that we need new taxes?

Ironically, one of the answers is staring them in the face if they would only look at it:  follow Colorado's example and legalize marijuana, then tax it.  Presto! New revenue stream, and--unlike casinos--it's very damn unlikely that New Jersey, Pennsylvania, or Maryland will be following suit anytime soon.

Not the mention the benefits of lowering prison costs, cutting out a major motivator for urban crime by undercutting gang economics, and treating people with serious drug problems as patients rather than criminals.

Oh, and we could fund Medicaid, too.

1 comment:

James Scarborough said...

I knew it was coming, although I didn't know it would happen this soon. Secretary Landgraf has made it clear that the Markell Administration was caught off guard with the accelerated quantitative easing. Lt. Gov. Denn mentioned in that debate way back with Sher Valenzuela that one of the biggest reasons why we accepted the Medicaid expansion was that the Federal Government agreed to pay for it. In the same breath he also left room for maneuvering. Should there be a pullback in temporary funds to the extent of causing significant budgetary problems, he essentially said Delaware would have to reconsider its participation in the Medicaid expansion.