Captain Rick: Dr. Thomas C. Patterson, an Arizona critic of Obamacare Medicaid expansion, explains why this expansion is bad and encourages all to “look behind the curtain.” These are important words as the Arizona Legislature votes on this monument expansion of welfare spending. Arizona is one of about 30 states that have not yet hitched their ‘train car’ to the ‘Obamacare Medicaid Expansion Train’ that is headed down a track that ends a few miles ahead at the edge of the real ‘Fiscal Cliff.’
Dr. Thomas C. Patterson is a graduate of Yale University and the University of Nebraska. He was elected to the Arizona State Senate in 1989, serving as minority leader from 1991 to 1992 and majority leader from 1993 to 1996. Patterson was the author of legislation creating Arizona’s charter school system and welfare reform program. Until 1998, he was a practicing physician and president of Emergency Physicians, Inc.. Patterson also served as president of the Arizona chapter of the American College of Emergency Physicians. In 2000 he became chairman of the Goldwater Institute. Tom is a retired physician and resident of Paradise Valley, Arizona.
I asked Tom why he was contributing his words to Atridim News Journal. Tom replied “I write it because I don’t want to be part of the generation that let liberty die out on our watch or at least I want to know that I did what I could to prevent it. I would like some of the good things about America to be there for my grand-children.”
Tom Patterson
The pressure from the Obama administration for Arizona to expand our Medicaid program is enormous. Gov. Brewer is on board and even some legislative conservatives seem to be wavering. But legislators should take one more look before they make what could be a fateful leap.
Here’s how it works. If we raise the eligibility requirements for Medicaid to 133 percent of Federal Poverty Level, the feds will drop additional subsidies of $1.3 billion annually into our state over the next three years.
Moreover, this raise can be accomplished with no general fund dollars. The state’s hospitals have agreed to pay additional taxes of $369 million to fund our share of the match. Gov. Brewer points out this is a phenomenal 10:1 “return on investment.”
When politicians use words like “investment” and “return”, your humbug detectors should start going off. If something seems too good to be true, it probably is.
First, the Obama administration pretty much struck out in their attempts to persuade states to establish insurance exchanges, so they’re frantic now to avoid a complete breakdown in the implementation of Obamacare. They’re pouring on the big bucks. But they’re spending borrowed dollars and that can’t last long.
For Arizona, taking on a financially unstable partner in a massive long-term venture wouldn’t be very smart. In fact, the feds are already considering extensive Medicaid cutbacks in their budget negotiations. The bigger point is that sharp reductions in the federal subsidy are a matter of when, not if. By 2020, even the promised subsidy ends. When that happens, Arizona will be left holding the bag.
That bag will be enormous. Of course, the rolls will be swollen by then with the eligibility expansion. But we will also be on the hook for the “woodwork effect”, the high number of patients who have been eligible for Medicaid but never signed up.
A 2010 Harvard study found that barely half of eligible Arizonans were signed up in AHCCCS (Arizona Health Care Cost Containment System), our Medicaid program. These are mostly younger, healthy people who don’t consume much medical care and don’t really need the insurance. If something happens, they can sign up any time.
But with the mandate under Obamacare to provide proof of coverage, the popularity of free insurance will skyrocket. In addition, employers with large numbers of low income workers may drop coverage or shift more workers to part time, making them Medicaid eligible under the new standards. Finally, people on SSI disability, a booming program, are automatically Medicaid eligible.
Medicaid costs have been ballooning 8 percent annually, compared to 1 to 2 percent economic growth. But apparently that’s not enough for the spenders. Total Medicaid spending under Obamacare is projected to grow from $400 billion to $900 billion by 2020. State budgets already stressed by high Medicaid spending will be in big trouble when they’re forced to pick up the tab.
The hospital tax is also deeply problematic. Hospitals are more than willing to go along, because it’s obviously in their best interests. But at heart, it is just a way to force paying patients to fund a welfare expansion that we can’t afford.
But there’s a bigger problem. The tax is unconstitutional unless approved by a two-thirds majority of the legislature. Proposition 108, a voter-passed amendment from 1992, states clearly that any net revenue increase to the state, including fees and special taxes, falls under its provisions.
The Brewer administration, recognizing it is unlikely that two-thirds of each house will sign off on their scheme, has tried to argue that the hospital tax is just a bureaucratically set fee and thus exempt. Whoops, there go the humbug sensors again. They’re not only almost certainly wrong, they’re playing with fire.
If they impose the bed text without legislative super-majority approval and it is later struck down, they would be in a world of hurt. They would lose their revenue and possibly their match and face gigantic Medicaid costs. Plus, there’s little meaning in prop 108’s super majority requirement if it doesn’t apply to this “fee”.
The more you look at this plan, the more serious problems keep bubbling up. Short-term, it has to be tempting to take the money. Ten years from now, the decision is going look a lot different.
Arizona legislators are under intense pressure to pass the Obamacare Medicaid expansion. They’re getting it from all sides.
“Do the math” the governor condescendingly demands, as if it takes special genius to figure out there is short-term gain in accepting these federal funds. “It’s your Christian duty” helpful ministers explain, apparently forgetting that Jesus preached personal compassion for the poor, not government lobbying.
Even the business community is on their case, claiming more Medicaid business will create jobs and stimulate the economy. Of course, if government spending really created net jobs, we would be awash in jobs because we have definitely tried massive spending in recent years.
The opponents of Medicaid expansion are commonly depicted as crazed ideologues blinkered by their opposition to Obamacare. After all, the creators of Obamacare were so frantic to get the states on board with the Medicaid piece that they agreed to provide near total funding initially for this nominally state-operated program. Even by 2012, they promise to provide 90 percent of the funds. Such a deal.
But Arizonans might be wise to look behind the curtain. As time rolls on, Obamacare is already defaulting on most of its key provisions.
For example, we were told that the average family would save $2500 annually on insurance premiums. It turns out the cost of health insurance will increase from $2100-$5000 yearly when Obamacare is fully implemented.
Obama himself promised that under his plan, “if you like your doctor, nothing will change”. Yet a recent poll from the consulting firm McKinsey estimated that over 40 million people will lose their employer-provided insurance. So much for that whopper.
The president also told us that no American families with incomes under $250,000 would see a tax hike. But there are over 20 new taxes in Obamacare. Many of them, like the tax on medical devices, a new tax on drugs, another tax on certain high-end health plans and reduced deductibility for medical expenses all fall squarely on the middle class.
There’s much more. We were told that Obamacare would cost “only” a trillion dollars over 10 years, that the costs would be partially offset by massive reductions in Medicare spending on the elderly, and that we would achieve virtually complete universal coverage. It’s all false, false, false. With a track record like that who could believe their next promise?
Gov. Brewer’s response is to create a “circuit-breaker”, a provision that calls for Arizona to revoke the benefits expansion if the federal funding falls below 80 percent. That sounds good and she is undoubtedly sincere. But she likely won’t be the governor when that day comes and whoever is will be under intense pressure to somehow maintain the program.
That’s the way the welfare state works, the “ratchet effect”. Whatever government provides, it’s never enough and the demands for more stuff never ceases. When benefits are granted, it’s nearly impossible to retract them.
So right here, in Arizona’s intense Medicaid debate, we see how Big Government rolls over and co-opts good people. It pulls the bait-and-switch, puts them in an untenable political position and forces them to support even this unpopular program that is certain to fail.
There is a growing recognition that Obamacare is an ugly hybrid, combining the worst aspects of government medicine and highly regulated private sector medical care. It was never intended by its advocates to be a permanent solution to America’s problems with affordability and access to care. Pres. Obama and others have candidly stated the real goal is a completely government controlled medical system.
That’s why it’s critical to stop Obamacare now and replace it rather than let it fail amid calls for a government takeover. We are going to end up either with medical care dictated by federal bureaucrats or one in which the power of free markets and patient choice prevail.
Real tort reform, price transparency, ability to buy insurance across state lines and many other possible reforms are out there, but we will never get them if the Obamacare train isn’t stopped.
Obamacare must have buy-in from the states to proceed. The stakes for the Legislature are enormous.
Captain Rick: After Tom’s commentary was posted, I asked Tom if my report served his words well. He replied “Everything is fine. Thanks for all your effort to alert Americans about erosions of our freedom. I am happy to be part of it”. Those words gave me great honor.
I welcome your comments, likes, shares and following of my blog! (If not visible, click the red title above)
Associated ATRIDIM NEWS JOURNAL Report Categories:
Medicaid: https://atridim.wordpress.com/category/medicaid/
Entitlement Reform: https://atridim.wordpress.com/category/entitlement-reform/
U.S. Debt Crisis: https://atridim.wordpress.com/category/u-s-debt-crisis/
Fiscal Cliff Course 101: https://atridim.wordpress.com/category/fiscal-cliff-course-101/
Arizona Law: https://atridim.wordpress.com/category/arizona-law/
Atridim News Journal 
Sandi Bartlett: Medicaid Expansion passes in Arizona … Its time to replace the ‘Bad Guys’
Posted: June 23, 2013 in Arizona Law, Guest Commentary, Medicaid, State GovernmentTags: AHCCCS, Andy Biggs, Andy Tobin, Arizona, Arizona Governor Jan Brewer, Arizona Health Care Cost Containment System, Arizona Law, Arizona Legislature, Arizona State Representatives, Arizona State Senators, atridim, Captain Rick, conservative politicians, deficit spending, Democrat, Federal Aid, Federal spending, fiscally responsibility, freedom, Health care, legislation, Legislators, Liberal, Liberty, Medicaid, Medicaid Expansion, National debt, Obamacare, political activist, politics, President Obama, Proper Vote, Republican, Republican Party, Sandi Bartlett, smaller government, State Government, Tea Party, Thomas Jefferson, U.S Spending, U.S. deficit, U.S. expenses, unalienable rights, Votes, Welfare
Captain Rick: Sandi Bartlett, an Arizona political activist for liberty, speaks of her disgust for Arizona’s passing of Medicaid expansion. She presents her ‘GOOD GUYS – BAD GUYS’ list of Arizona Senators and Representatives who voted against/for the legislation.
Sandi is an energetic and dedicated person who works tirelessly in Legislative District 17 of Arizona to ensure that citizens are paying attention to important political events and our Senators and Representatives cast the proper vote. Such was the case in recent weeks as Sandi worked with intensity to stop the $300,000 annual expansion of Medicaid in Arizona. The ‘Obama carrot’ of nearly 100% of expansion costs being covered by the federal government, paid for by more debt dollars on top of America’s already massive $17 trillion debt, is a fiscal hoax that will not last. That ‘carrot’ will soon be replaced with fiscal realism and Arizona will be stuck paying the expansion costs. Sandi’s insight of this fortifies her dedication and motivation.
I invited Sandi to present guest commentary. She graciously accepted. I am confident you will enjoy this…
Guest Commentary
by
Sandi Bartlett
I am an average citizen who was never involved in politics until later in life. I became involved when I felt that the Government was growing too large and out of control. Our liberty and freedoms were rapidly being taken. I felt I was alone until I met many people who felt the same way. I now see that the Government is only as good as the people we elect and how knowledgeable we are. So I set out to elect the best person for our district and spent close to 2 years working to elect Matt Salmon (U.S. Congressman – Arizona District 5) . Now I am an active Precinct Committeeman, on the board of the East Valley Tea Party and Arizona Legislative District 17 board member.
The Republican Party is soul searching at this time. Our party is diverse and I try to respect the opinions of everyone because the issues are not easy. However, we must find a way to be on offense rather than defense. Take action to grow the party and find solutions to our problems. We should try to stay focused and positive. Show others that we are an inclusive party and welcome those who believe in smaller government, fiscally responsibility, freedom and liberty even though how we achieve those goals may differ.
I plan to continue my efforts in electing honest conservative politicians and then holding their feet to the fire. Our Republic depends on the citizens to be actively involved and not let the government take away our unalienable rights. Thomas Jefferson said “The natural progress of things is for liberty to yield, and government to gain ground.” We must not let that happen any more than it already has.
I will keep fighting the good fight.
Medicaid Expansion in Arizona has passed despite all of the hard work in opposition
The house session was appalling and disrespectful. For 12 hours or more the Democrats and 9 Liberal Republicans would not answer a single question from our good Republicans about the budget or Medicaid Expansion. If they thought the budget and bill was so great, they should have defended it by answering questions. It was if Arizona Governor Jan Brewer had placed taped over their mouths so they could not speak for themselves. Jan Brewer was willing to remove Arizona Senator Andy Biggs and Arizona Representative Andy Tobin from their leadership position to get this done. Outrageous !!
I was so proud of our “good” Republicans. Their floor speeches were passionate but you could feel the anger in that room. They stood tall and tried their best to flip some of the Liberal Republicans but in the end could not. They deserve our praise for fighting the good fight.
I really held back my true feelings after watching 8 hours of that session. It was really enlightening but very discouraging. It is no wonder our government whether it is state or federal is in such disarray. I am more motivated than ever to elect the best candidates for office. I hope that plans are being made in each of these districts that voted for Medicaid expansion to run someone in the primary. We must not forget the rallies and numerous contacts that we made with them with no success. The tactics they used to pass this Medicaid expansion was disgraceful.
Final Voting Results on Medicaid Expansion in the Arizona State House and Senate
Sandi Bartlett’s GOOD GUYS – BAD GUYS List
GOOD GUYS voted against Medicaid Expansion – BAD GUYS voted for Medicaid Expansion
Data listing order: Last Name, First Name, District Number (all are Republican)
BAD GUYS – ARIZONA HOUSE – 2013
Brophy McGee, Kate, 28
Carter, Heather, 15
Coleman, Douglas, 16
Dial, Jeff, 18
Goodale, Doris, 5
Orr, Ethan, 9
Pratt, Frank, 8
Robson, Bob
Shope, Thomas, “T.J.”, 8
BAD GUYS – ARIZONA SENATE – 2013
Crandall, Richard, 16
Driggs, Adam, 28
McComish, John, 18
Pierce, Steve, 1
Worsley, Bob, 25
GOOD GUYS – ARIZONA HOUSE – 2013
Allen, John, 15
Barton, Brenda, 6
Borrelli, Sonny, 5
Boyer, Paul, 20
Fann, Karen, 1
Farnsworth, Eddie, 12
Forese, Tom, 17
Gowan, David, 14
Gray, Rick, 21
Kavanagh, Joh, 23
Kwasman, Adam, 11
Lesko, Debbie, 21
Livingston, David, 22
Lovas, Phil, 22
Mesnard, Javan “JD”, 17
Mitchell, Darin, 13
Montenegro, Steve, 13
Olson, Justin, 25
Petersen, Warren, 12
Pierce, Justin, 25
Seel, Carl, 20
Smith, Steve, 11
Stevens, David W., 14
Thorpe, Bob, 6
Tobin, Andy, 1
Townsend, Kelly, 16
Ugenti, Michelle, 23
GOOD GUYS – ARIZONA SENATE – 2013
Barto, Nancy, 15
Biggs, Andy, 12
Burges, Judy, 22
Crandell, Chester, 6
Griffin, Gail, 14
Melvin, Al, 11
Murphy, Rick, 21
Shooter, Don, 13
Ward, Kelli, 5
Yarbrough, Steve, 17
Yee, Kimberly, 20
UNDECIDED – ARIZONA SENATE – 2013
Reagan, Michele, 8 (She voted Yes in the first vote out of the Senate and No in the final vote.)
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I welcome your comments, likes, shares and following of my blog! (If not visible, click the red title above)
Associated ATRIDIM NEWS JOURNAL Report Categories:
Medicaid: https://atridim.wordpress.com/category/medicaid/
U.S. Debt Crisis: https://atridim.wordpress.com/category/u-s-debt-crisis/
Captain Rick’s Fiscal Cliff Course 101: https://atridim.wordpress.com/category/fiscal-cliff-course-101/
Federal Grants: https://atridim.wordpress.com/category/federal-grants/
Obamacare: https://atridim.wordpress.com/category/obamacare/
State Government: https://atridim.wordpress.com/category/state-government/