‘Waivers are temporary but expansion is forever’
For Immediate Release
Monday, Aug. 26, 2013
Media Relations Manager
MIDLAND — Michigan legislators who favor expanding Medicaid under the Affordable Care Act (“Obamacare”), because they believe the waivers they want to implement will be approved by the federal government, should take caution, according to a new study released today jointly by the Mackinac Center for Public Policy and The Buckeye Institute in Ohio.
“The title says it all — waivers are temporary but expansion is forever,” said Jack McHugh, senior legislative analyst. “Legislators here who keep proposing what they regard as reasonable reforms as a condition for accepting the expansion may be in for a rude awakening when this reality begins to bite.”
The paper was co-authored by Robert Alt, president of the Buckeye Institute, and Nathanial Stewart, a visiting fellow at the Institute. The authors were assisted by Ed Haislmaier, senior research fellow at The Heritage Foundation, and Dennis Smith, former director of the Center for Medicaid and State Operations at the Centers of Medicare and Medicaid Services.
Alt and Stewart describe how Medicaid waivers work and outline three reasons for states to be cautious about relying on such waivers to reform their Medicaid programs: waivers are temporary, subject to the discretion of federal bureaucrats and, even when approved, vulnerable to judicial review. The study examines the Medicaid waiver and reform experiences of various states — including Oklahoma, Indiana and Connecticut — that have been curtailed, denied or turned down for renewal.
“There’s nothing special about Michigan that would make the federal Department of Health and Human Services rubber-stamp whatever schemes legislators here imagine they can demand,” McHugh added. “Going hat-in-hand to Washington, D.C., every few years to request ‘mother-may-I’ exceptions from federal rules is no way to reform this state’s health care and medical welfare systems.”
Alt and Stewart write in the conclusion, “Policymakers should resist the temptation to go along on the attenuated hope that Washington will allow them latitude in designing long-term cost-saving and delivery measures.”
The new paper comes on the heels of a recent Mackinac Center study that revealed several flaws with Medicaid expansion, including increased costs to Michigan taxpayers of $1.3 billion over the next decade, and previous studies that show as many as 60 percent of those who enroll in Medicaid expansions drop private insurance in order to do so.
The Mackinac Center for Public Policy is a research and educational institute headquartered in Midland, Mich. The largest state-based free-market think tank in the country celebrates its 25th anniversary this year.
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