Las Vegas Sun

October 23, 2017

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Sun Editorial:

Medicaid an opportunity

Nevada could bolster health care, economy with program expansion

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In its ruling this year upholding Obama­care, the U.S. Supreme Court gave states the ability to opt out of a provision to expand Medicaid, which helps provide health insurance to people with low incomes.

In a bow to conservatives, several Republican governors have refused to expand the program. Nevada Gov. Brian Sandoval, a Republican, has yet to announce whether he will seek the expansion of the state’s program.

As Sandoval studies the issue, we hope he sees the clear reasons to expand the program. Medicaid provides access to health insurance for millions of Americans, and expanding it is the moral thing to do. There’s no reason to let people suffer and die with treatable ailments because they can’t get insurance. And covering the uninsured makes good fiscal sense, too, because it would reduce some significant costs.

However, the debate about Medicaid expansion has been muddied by falsehoods and vitriol. For example, there still are complaints about a government “takeover” and “rationing” of health care. (There’s no takeover; the law mandates that people buy private health insurance. And if the critics are concerned about rationing, why aren’t they complaining about the private, for-profit insurance companies that are now making life-and-death decisions in doling out care?)

We also have heard the cries that the expansion will harm health care: With more people insured, there will be competition for health care services. In some corners of Nevada, where the concentration of health care services lags behind other states, there is a worry that adding more people seeking care to an already-stressed system will create a scarcity of services.

It’s odd to hear the conservative critics complaining about competition because they normally see that as a good thing. (It’s the way the free market is supposed to work, isn’t it?) Besides, adding more people creates more demand, and the market will rise up to meet that demand, won’t it?

It should, and that’s one reason Sandoval should pursue expanding Medicaid. It will give the state’s health care system — and the economy — a much-needed boost.

This year, Sandoval called for creating 50,000 jobs, and the expansion of Medicaid presents a great opportunity toward meeting that goal.

Health and medical services play a prominent role in the economic development study issued last year by the Brookings Institution and SRI International. It’s a growth industry that offers good-paying jobs, and expanding Medicaid would help push the economy along.

There are concerns about the state’s cost of expanding Medicaid, but what can’t be overlooked is that taxpayers and people with insurance already are paying for the treatment of the uninsured. And it’s not an insignificant amount. What happens is that those without insurance let ailments linger, which exacerbates their problems. When they seek treatment, they tend to go to hospital emergency rooms with more advanced ailments than if they had seen a primary care doctor. The costs of their hospital care are passed on to taxpayers, who fund public hospitals, and people with insurance, who face higher rates as a result.

Clark County’s public hospital, UMC, is on the hook every year for tens of millions of dollars due to treating uninsured people. Expanding Medicaid would cut down on those expenses as well as alleviate some needless suffering.

The bottom line is that this makes sense, and Sandoval should support the expansion of Medicaid for the health of Nevada, both physically and economically.

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