Some bad ideas never die. I was reminded of that recently when liberal columnist Scott Maxwell went on another tear in The Orlando Sentinel criticizing the Florida legislature for failing to expand Medicaid.

The Sentinel has devolved into a propaganda machine for the Democratic Party and Maxwell is one of their fiercest defenders. They hate Governor Ron DeSantis, mostly because he’s become a rock-star in the Republican Party and a likely presidential candidate in 2024. Rather than respond to his article in The Sentinel, which is unlikely to print a differing opinion, I’ll just let you read my rebuttal to this argument that I posted in 2015. The same issues were debated back then and the same responses are still appropriate today.

Here is my response previously published on 11/10/15:

 

Medicaid Expansion Causing Buyer’s Remorse

Marketing can be deceiving. Like those book clubs that offer you free books to choose up front, but then obligate you to buying books in the future.

The buyer’s remorse of book club members is now being felt by state lawmakers who chose to expand Medicaid under The Affordable Care Act (ObamaCare). The government promised “free” Medicaid expansion for the first three years with declining support after 2016. Already the states that agreed to this deceptive deal are seeing the errors of their choice.

Thirty states and the District of Columbia took the deal and expanded Medicaid. Democratic lobbyists have joined with state hospital lobbies to pressure lawmakers in the remaining 20 states to follow. As a resident of Florida, I have seen this battle in my own statehouse.

Evelyn Everton and Chris Hudson, state directors of the Utah and Florida chapters of Americans for Prosperity,write of their state’s experience in The Wall Street Journal.

The Utah state Senate passed a Medicaid expansion bill backed by Gov. Gary Herbert, who promoted the “free money” argument during his January State of the State address. The more conservative House, which noted the proposal’s $328 million price tag over 10 years, never passed the bill out of committee.

The battle in the state of Florida was even more heated. The Florida Senate tried to fold Medicaid expansion into the state’s annual budget. According to the Florida Senate Committee on Appropriations, the cost to the state taxpayers would be $96.6 million in the first two years, and a yet-to-be-determined amount when the state assumed its full 10% share in 2020. The Florida House refused to pass the bill. A budget stand-off led to a 20-day special session in June. The House again rejected the Senate proposal by 72-41 after seven hours of debate.

Did Utah and Florida do the right thing by rejecting Medicaid expansion?

The experience of those states that did expand Medicaid is now coming into focus. The Associated Press reported in July, “At least 14 states have seen new enrollments exceed their original projections, causing at least seven to increase their cost estimates for 2017.” 

The AP says that California expected 800,000 new enrollees after the state’s 2013 Medicaid expansion. The real number was 2.3 million. In New Mexico, new enrollment exceeded estimates by 44%. In Oregon actual enrollment exceeded expectations by 73% and in the state of Washington by more than 100%.

Needless to say this has crushed the budgets of these states. Illinois once projected that its Medicaid expansion would cost the state $573 million for 2017 through 2020. But enrollment has exceeded expectations by 200,000, leading to a new price tag of about $2 billion, according to the Chicago Tribune.

The situation is similar in Kentucky, often trumpeted by ObamaCare supporters as a model for others to follow. But enrollment numbers in Kentucky have forced officials to more than double the anticipated cost of the state’s Medicaid expansion for 2017. Original cost estimates of $33 million have risen to $74 million – and some estimate this number will grow to $363 million per year by 2021.

The Kentucky Health Cooperative, the largest insurer on the ObamaCare exchange, also imploded in October, leaving 51,000 residents without coverage. The uproar in the state was a major factor in the recent elections that swept Republican Matt Bevin into the governor’s mansion replacing Democratic Governor Steve Beshear, who was responsible for both the Co-Op and the expansion of Medicaid.

Even in Ohio, where Governor John Kasich is running for president and strongly defending his move to expand Medicaid, there is brewing trouble. State spending on the program has grown by $5.8 billion since 2011. The Ohio Department of Medicaid projects that by 2017 spending will total $28.2 billion – a 59% increase during Gov. Kasich’s tenure – according to The Wall Street Journal.

Of course, unlike the federal government, which can run deficits, state governments must balance their budgets. That means hard choices between spending money on healthcare and other key priorities like education and infrastructure. When Medicaid spending skyrockets they are left with cutting spending on these other vital services, raising taxes, or both.

Everton and Hudson praise the Utah and Florida legislatures for resisting the temptation to expand Medicaid with “free money” from the government. It’s a good reminder of a truism we all should have learned long ago – there is no such thing as a free lunch!

 

 

It’s now been three weeks since the FDA granted EUA (Emergency Use Authorization) to Pfizer/BioNTech to begin vaccinating children ages 12 to 15 years. Prior EUA was limited to adolescents age 16 or older. Moderna is expected to receive EUA for their vaccine in this same age group very soon.

The latest information from Pfizer/BioNTech says their vaccines is 93% effective in clinical trials after one dose and 100% effective after two doses. There have been no cases of Covid-19 in these children who have been fully vaccinated.

Common side effects are pain at the injection site, some swelling, body aches, low fever, and enlarged lymph nodes according to Dr. Salma Elfaki, Orlando pediatrician who ran the trials for Moderna’s 12 to 17 trials in Central Florida. “The worst case lasted maybe a week.”

Kate Santich, writing in The Orlando Sentinel, says doctors and health officials in Central Florida are worried that many eligible 12- to 17-year-olds will decline the vaccine shots. This may result in Covid-19 infections in these children, and worse, in their household grownups.

Some recent statistics are revealing. Although the risk of Covid-19 causing serious illness and death in children is extremely low, it is not zero. Dr. Elfaki noted that more than 1,300 Florida youth from babies to age 14 have been hospitalized with the virus, and seven have died. In the 15-to 24-year-old category, 2,400 Floridians have been hospitalized and 53 have died. These are not insignificant numbers.

There is also a severe pediatric reaction to the virus that has been seen in a few pediatric cases involving multisystem inflammatory syndrome in children, or MIS-C – in which the infection triggers a battle with the host that can damage major organs and lead to death. As of May 3, Florida had reported more than 150 cases like this.

Nevertheless, skepticism about the vaccine is running higher than in adults. “The split is about 60/40 – with 60% hesitant,” Elfaki said of parents in her private practice. “I understand their hesitancy. Obviously, everybody feels it’s fairly new, and they want to wait a little bit and see if anything pans out. But I try to educate them on the numbers, which have shown the vaccines to be extremely safe.”

This degree of skepticism is not limited to Florida. A nationwide survey in May of nearly 22,000 parents in all 50 states found about 27% of mothers and 11% of fathers say they are extremely unlikely to vaccinate their children against Covid-19. I would blame this skepticism on the misinformation about vaccines and childhood autism that began years ago with a false claim in the British medical journal Lancet that the measles vaccine caused autism. Lancet later retracted this report when it found the research behind it was bogus. Yet celebrities promoted this falsehood and many parents still believe their lies.

Dr. Kenneth Alexander, chief of infectious disease at Nemours Children’s Hospital in Orlando, blames the nation’s current cultural climate. “We Americans are sort of hold-outs. We haven’t had serious at-school vaccination, really, since the 1950s,” he said. “Whereas for the rest of the world, this is actually how children routinely get vaccinated. And parents there think this is normal. We’re a global anomaly.” 

There have been reports of a mild inflammation of the heart seen in some children. But the CDC says the condition is extremely rare, typically mild, and not found at a greater rate among vaccinated youth than unvaccinated ones. These anecdotal reports only serve to increase parental anxiety, even when the science fails to demonstrate a connection.

No parent should be worried about the cost of getting their child vaccinated. The Vaccines for Children Program was established by the federal government in 1994. Children from birth through age 18 years are eligible to receive free vaccines if they:

• Are enrolled in Medicaid
• Have no health insurance
• Are American Indians or native Alaskans
• Are covered by a health insurance plan that does not include vaccines

 

I would encourage anyone, adult or child, to get vaccinated unless they have a medical condition that makes them at high risk if they receive the vaccine. We are blessed to have safe, effective, widely available vaccines now for this dreaded disease. Take advantage of these medical breakthroughs to allow you and your family to get back to life.