Monday, November 02, 2015

Medicaid vs Insurance

So, over on Twitter (among other places), folks have been crowing that Medicaid expansion has contributed mightily in bringing down the number of uninsured. I politely pointed out that Medicaid ≠ insurance, which then set off a storm of protests:

"CHIP has the word insurance in the title."

 Abraham Lincoln had an answer for that one.

I also pointed out that (obviously) insurance = risk + premium, while Medicaid = income redistribution.

They didn't like that either:


It's really a very simple thing, so I challenged my detractors to "name an insurance company that sells Medicaid policies."

FoIB Allison Bell gamely offered "Anthem, UnitedHealth, Aetna, Centene" as examples. This refers to carriers which have entered into agreements with states seeking to "privatize" Medicaid.

Unfortunately, this answer also doesn't fly, for the simple reason that these carriers don't "sell" Medicaid policies, they administer Medicaid for participating states. They are paid by taxpayers as a whole, not individual policyholders.

Nice try, though!

The salient point here is that Medicaid beneficiaries [ed: hey - that's another clue!], unlike those who purchase insurance, have no skin in the game. Now, one could make the case that neither do folks who "buy" fully subsidized ObamaPlans, but that's another post. 

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