On Friday, we learned that the Obama economy has hit stall speed, with a paltry 113,000 jobs added in January.
Two days earlier, we learned the president’s health care law is discouraging Americans from working, according to an analysis by the nonpartisan Congressional Budget Office. The report makes for bracing reading. The law will reduce the labor supply by the equivalent of 2.3 million full-time workers, the CBO says — up from an estimated 800,000 just three years ago.
It gets worse. The CBO also concluded that the law’s “expanded Medicaid eligibility … will, on balance, reduce incentives to work.” Think about that: Obamacare is giving low-income Americans fewer reasons to work — to find and pursue the jobs that could transform their lives and the lives of those around them. The president talks a lot about tackling inequality. But his health care law is a recipe for increasing inequality, not decreasing it.
Obamacare’s Medicaid expansion doesn’t just discourage work; it also prioritizes coverage for able-bodied adults over the needs of persons with disabilities. That’s a dirty little secret the Obama administration and its liberal allies, in their rush to expand government-funded health coverage to millions more Americans, won’t tell you. And it’s yet another reason why states should resist the siren song of the administration and its leftist supporters, who plan to spend 2014 persuading them to embrace the expansion.
According to the Kaiser Family Foundation, in 2012 more than half a million seniors and people with disabilities on state Medicaid lists were awaiting access to home and community-based services. Prompt access to these services could keep individuals with disabilities out of institutions, which are often more costly.
Yet Obamacare provides states with a much greater federal Medicaid match — 100 percent for the first three years, phasing down to 90 percent over time — to cover previously ineligible low-income individuals. According to the Urban Institute, nearly five in six adults to be covered under the Medicaid expansion are adults without children, most in their prime working years.
In other words, Obamacare’s incentive structure places a greater emphasis on expanding coverage to these able-bodied adults — the vast majority of whom could be working or preparing for work — than helping the individuals with disabilities Medicaid was initially created to serve.
That’s not compassionate — just the opposite, in fact. So while the president’s advisers ask why states aren’t expanding Medicaid under Obamacare, I have another question for President Obama: Why is expanding Medicaid to cover millions of working-age Americans a bigger priority than giving access to hundreds of thousands of people with disabilities waiting for care?
To me, the answer is simple: It shouldn’t be. I won’t take lectures on compassion from those whose skewed priorities jeopardize critical coverage for America’s neediest citizens, those for whom Medicaid was designed. Expanding eligibility to working adults will only crowd out resources that should be invested in caring for our most vulnerable. That’s why my administration is focused on reforming our Medicaid system to extend access to critical services for people with disabilities, not participating in Obamacare’s massive and costly expansion to new categories of individuals. We have also focused on improving health care coverage for another population Medicaid was originally designed to protect: uninsured children. I am proud to say that 95.6 percent of Louisiana children have health insurance.
In Louisiana we are focused on strengthening the safety net for children and people with disabilities. Our proposed budget for next fiscal year includes $26 million in new funding of home and community-based services for elderly individuals and people with disabilities — part of a 50 percent increase in spending on these services since we took office. We’ve increased the number of participants in home and community-based programs by nearly 5,000 people, and this year’s funding ultimately will reduce waiting lists by more than 4,000. We also are in the process of designing a major transformation of these programs that will result in better-integrated and coordinated care.
Helping people stay healthier and more independent not only improves quality of life, it saves money. And those savings can be reinvested in these programs to serve more Americans and shorten the wait for these critical services.
Obama has defended his health care law by stating, “We are a compassionate nation”— implying that the millions who oppose it are not. That’s as wrong as it is insulting. A law that gives Americans with low income additional incentives not to work and prioritizes able-bodied adults ahead of persons with disabilities demonstrates a fundamentally flawed definition of “compassion.”
I firmly believe that government has a responsibility to ensure an effective safety net for the least fortunate among us. But we can’t be everything to everyone, and we still haven’t met the needs of our most vulnerable. That’s why I’m going to make my priority expanding access to better services for older Louisianians and those with disabilities. I only wish the president would do the same.