by Mitch Kokai
Senior Political Analyst, John Locke Foundation
The subheadline of Nicholas Horton’s National Review Online column uses those terms to describe a proposal North Carolina legislative leaders have been fighting ever since the Affordable Care Act squeaked through a deeply divided Congress.
It’s not the lead story on the nightly news, and it’s not generating millions of clicks online. It may be one of the most underreported, underappreciated public-policy crises of our time. That’s a terrifying reality because, left unaddressed, this crisis will come at great cost to America’s most vulnerable.
The Medicaid program is at its breaking point. Even before Obamacare lured some states into expanding the program to non-disabled, working-age adults, Medicaid was growing at an alarming rate. Now, in the Obamacare era, the program is growing even faster, siphoning more and more resources away from folks who truly depend on Medicaid for survival.
A new report, released this week by the Foundation for Government Accountability, gives a glimpse of just how serious the problem is.
For starters, overall Medicaid enrollment has more than doubled since 2000. The number of able-bodied adults in the program has more than quadrupled over that same period.
This enrollment explosion has generated an unprecedented spending surge. Since 2000, total Medicaid spending has more than tripled, rising from $206 billion to more than $600 billion this fiscal year. Medicaid spending on able-bodied adults alone has skyrocketed by more than 700 percent.
Every one of these dollars is a dollar that cannot be spent on truly needy individuals who depend on Medicaid to survive — children, seniors, and individuals with disabilities. And with Medicaid now consuming roughly one out of every three dollars in state budgets, fewer dollars are left not only for the truly needy but for education, infrastructure, and public safety.
That’s a lot of numbers, but the bottom line is simple: Medicaid is nearing the end of an unsustainable path.