Ask Old People if Medicaid Is Really an "Entitlement Black Hole"

Colorado State Sen. Laura Woods suggested in a radio interview last month that state Republicans wanted Gov. John Hickenlooper to cut health-care for children, elderly, the disabled, and other poor people in exchange for the allowing the state to spend $370 million in TABOR rebates on roads, schools, and other state programs.

"All we had been asking, the entire [legislative] session, was for some real Medicaid reform -- Medicaid expansion reform -- real reform in that area," Woods told KNUS host Jimmy Sengenberger May 14 (below). "Mr. Governor, if that's what you want, then bring us some real reform ideas and an assurance that this money would not just be sucked into another health insurance expansion entitlement black hole, like all of -- 38% of our state budget already is. And they wouldn't come back with any ideas. So they really -- you know, we gave them an alternative, [we] said, 'Come to us with this.' And they wouldn't come back with any suggestions on that. So, that's a long-winded answer to a good question."

Medicaid, Colorado's federal-state health care program for low-income people, is apparently what Woods, a Republican from Westminster, refers to as an "entitlement black hole." Under Obamacare, some 350,000 more Coloradans enrolled in Medicaid, bringing the total number of Colorado enrollees to over 1.1 million.

"Medicaid expansion has been a win on many levels for Colorado, largely because it has expanded health care access to so many Coloradans, putting Coloradans on the path to better health, and because it's benefiting our economy," said Natalie O'Donnell Wood, senior policy analyst at the Bell Policy Center. "Colorado's rising Medicaid costs are and will continue to be largely attributable to the aging of our population, not Medicaid expansion."

The federal government picked up most of the tab for Coloradans who enrolled in Medicaid as part of Obamacare. Despite this, Senate President Bill Cadman and other Republicans have falsely asserted that Medicaid expansion, under Obamacare, is busting Colorado's budget.

Unlike Cadman, who doesn't explain how he'd like Colorado to cut Medicaid, Woods has said she wants people to be poorer to qualify for Medicaid. But on KNUS, she suggested that in negotiations with Hickenlooper over the hospital provider fee, Republicans did not specify the Medicaid cuts they sought. The GOP wanted Hick to come to the table with "real reform ideas," she said.

For Republicans, explaining how to cut Medicaid, and why, is tricky politically, and not only because the program covers segments of the population that elicit empathy among voters: children, the elderly, disabled, and poor people. Who should be cut? Or even, who should pay more fees?

The other problem for Republicans, in specifying Medicaid cuts, is that the reason Colorado's Medicaid costs are increasing is not due to Medicaid expansion under Obamacare.

Instead, as the Bell Policy Center repeatedly points out, it's the increasing need for long-term care of the growing elderly poplulation. Long-term care is not covered by Medicare, the federal health insurance program for the elderly. Older poeple, who may have had private insurance when they were younger, turn to Medicaid when they've spent down their savings on long-term care.

So, if you're a Republican, you run into political problems if you say, "Let's get Medicaid costs under control by trimming the part that's driving up costs: old people." Many of whom, incidentally, were middle class before long-term care sucked away their money.

If you're Laura Woods the political traps apparently don't bother you, and you say Medicaid is an "entitlement black hole" and people need to be even poorer to qualify for it.

But if you're Cadman or other Republicans, and you're actually worried about what people might think (and how they might vote) if you propose cutting health care for vulnerable people, you chest thump without getting into the specifics.