State senator misrepresented facts on expanded Medicaid

Which of our neighbors should be denied a checkup from a family doctor? Who should go without the preventative cancer screening today that could save their life tomorrow?

Montana could provide excellent health insurance for up to 70,000 uninsured Montanans for three years by simply accepting available federal funds. Instead, earlier this year, an unbending cadre of extreme legislators put politics before people and blocked a compromise to expand our state’s Medicaid program. Their obstruction means federal dollars meant for Montana instead head to states like California and New Jersey.

Expanding our existing Medicaid program makes sense for Montana. Medicaid is efficient and effective insurance, and expansion would come at little cost to the state. The first three years of expansion would have been covered by federal funds. After that, state funds would start to offset the cost, but Montana would never contribute more than 10 percent of the total. Medicaid would give families the ability to see a doctor when they’re sick, without the worry of financial ruin.

Last month, state Sen. Fred Thomas (R-Stevensville) misrepresented the facts in his opinion piece. He erroneously claimed Medicaid expansion would increase healthcare costs and come at a great expense to Montana. These claims simply aren’t true.

In fact, Sen. Thomas and his colleagues denied a $1 billion federal investment and more than 12,000 jobs. Expanding Medicaid effectively increases demand for medical services, as the newly insured get the care they need. Increased demand allows medical facilities to purchase new equipment and hire additional staff.

What’s more, expansion would also decrease uncompensated care costs and strengthen critical access hospitals and rural clinics. Preventing disease — or treating them early — is less expensive in the long run than waiting until they require emergency room or hospital care.

In my role as a faculty physician for the Montana Family Medicine Residency in Billings, I teach resident physicians to critically examine research studies. Sen. Thomas selectively discussed only anti-Medicaid statistics from a study of newly enrolled Medicaid beneficiaries in Oregon. In truth, the “Oregon Experiment” created significant benefits within the first year, which was the focus of the study.

Recipients were 40 percent less likely to report having to borrow money or skip payments due to medical expenses, and 25 percent less likely to have medical bills go into collection. New Medicaid recipients were also 25 percent more likely to report good health and 25 percent less likely to screen positive for depression. They were 70 percent more likely to report having a regular place of health care, 55 percent more likely to have a usual doctor, and the rate of getting recommended mammograms increased 60 percent.

(Note: In the follow-up study, obtaining Medicaid “nearly eliminated catastrophic out-of-pocket medical expenditures.” These are all important health-related outcomes that Sen. Thomas chose to ignore, but which are important to incorporate into any honest discussion.)

This demonstrated value is why support for expanding Medicaid is broad and diverse. Doctors, nurses, veterans, rural hospitals and clinics, business leaders, labor organizations, the Montana Association of Churches, and the Montana Chamber of Commerce all supported a legislative compromise.

Extremist politicians should not stand in the way of meeting the basic needs of Montanans. Our citizens deserve the dignity afforded them by access to health care. In order to do so, we need elected officials like Sen. Thomas to put Montanans before politics, come back to the table, and offer a solution.

Dr. Michael D. Geurin is a clinical associate professor of family medicine at the University of Washington and a faculty physician at Montana Family Medicine Residency, in Billings.