Letter: Reader says a Medicaid expansion is needed and argues John Hood's opposition

A recent John Hood letter details his opposition to Medicaid expansion, and he makes some wild claims.

First, he says that supporters think the expansion is free. No, we don't. We understand how taxation works and that an expansion funded by taxes is inherently not free. However, taxpayer funding means it is heavily reduced in per-person spending since everybody is contributing. Hood knows this, but that doesn't fit his narrative.

Second, he says a 2017 study indicated a 2.5 visits per 1,000 increase in ED (emergency department) visits, but he doesn't mention other studies such as "Evidence of Pent-Up Demand for Care After Medicaid Expansion" showed "consistent with pent-up demand among new enrollees, the probability of an office visit, a new patient office visit and an emergency department visit declines over time for new enrollees relative to ongoing Medicaid enrollees."

Finally, he states the "National Bureau of Economic Research found no measurement improvement" for "costly and debilitating diseases" such as asthma and diabetes.

That is interesting since a recent NBER study ("Medicaid and Mortality: New Evidence from Linked Survey and Administrative Data") found "the authors estimate that Medicaid expansion led to 4,800 fewer deaths per year among adults aged 55-64" and "authors estimate that a mere $10.40 increase in coinsurance led to a 32.7 percent increase in monthly mortality." They also found "... consistent with a wide body of research, this analysis finds that enrollees who cut back on care in response to higher out-of-pocket costs also reduce use of needed, high-value care like prescription drugs (and increase the likelihood of death)." The simple lack of a $10.40 expansion in care saw a nearly 33 percent increase in mortality.

Expansion is needed, works and is a pittance compared to current prices. We shouldn't need expansion, but lack of government regulations on the industry force our hand. I agree that better reform is needed, but expansion is a good stepping stone and stopgap to it. I'm ignoring his atrocious victim-blaming declaring lack of "personal responsibility" as being a reason for the need of Medicaid.

ERIK DAVIS

Asheboro

This article originally appeared on The Courier-Tribune: Reader supports Medicaid expansion, argues against John Hood's claims