Medicaid: A Cultural Crisis
BY LIZZIE MARGOLIUS
In 1974, at the age of 34, my mom became a widow. She had my brother, who was only four years old and she had no job. I remember my mom telling me that she had to go downtown to apply for welfare. My mom said she was humiliated and embarrassed and she vowed she would never be in a situation again where she had to depend on the government for any assistance. My mom wasn’t unique in this mindset. At one time rejecting government assistance was the norm, but not today.
Today Medicaid alone eats up about 45-50% of our state budget and continues to grow, while taking up a greater percentage each year of the state budget. The state of Ohio currently outpaces the national average on spending for Medicaid.
How did we get here? There are two major contributors to our Medicaid explosion: John Kasich’s expansion of Medicaid and cultural acceptance.
In 2013 John Kasich, in his infinite wisdom, decided that he was going to expand Medicaid under Obamacare and since doing so, has added more than three quarters of a million more people to Medicaid. Kasich even famously said in an NPR interview “if other people don’t want to take the money, that’s up to them, but I got money I can bring home to Ohio.” Uh huh. Typical politician. Follow the “free money” and grab as much as you can. Reminder: the government does not produce anything. The “free money” comes from you and I. Kasich wanted to rob Peter (federal government dollars…A.K.A. our tax dollars) to pay Paul (state government dollars…A.K.A. our tax dollars). Even today, Republicans from the Ohio legislature will quickly follow up with “but it only costs us 10 cents (A.K.A. our tax dollars) on the dollar to keep those people on Medicaid” (the federal government pays the other 90 cents…A.K.A. our tax dollars). And that, my friend, is exactly what is wrong with our state. We pay for it regardless of where the tax dollars come from. But more importantly, why are we encouraging a culture of dependency?
Today half of all babies born in Ohio are born on Medicaid. Almost half of all children in the state of Ohio are enrolled on Medicaid.
Today 25% of our state population (3 million) is enrolled in Medicaid. 1 in every 4 people.
Culturally, we live in a world where everything is a right and anything goes. I hate to break it to you, but healthcare is not a right. Hundreds of years ago before hospital systems and large medical enterprises ran the world, you were not guaranteed healthcare. We didn’t have healthcare. Today it’s okay to be on the dole for everything from subsidized housing to food stamps, healthcare, and even the infamous Obama phone. But decades ago, it was an embarrassment to need government help. People relied on their neighbors, churches, and communities to get them through the hard times.
Michael Shellenberger, the author of San Fransicko, did a deep dive into drug cultures in other parts of the world and what he uncovered was that some countries have way more lenient laws regarding drug usage, but have lower drug usage rates and lower rates of addiction. How can that be? Well, in those countries, using drugs is simply not culturally acceptable. Society does not incentivize nor normalize that behavior. In Ohio we need to stop incentivizing and normalizing Medicaid. It’s not normal that 25% of our population needs the government to pay for their healthcare.
We’ve seen a 41% increase in state spending from 2019 to 2024 with much of that increase being caused by public assistance programs. Medicaid in Ohio grew by almost 1 million people from 2020 to 2024. Thank you DeWine.
Not only do we need to fight our own government against promoting a culture of dependency and fight society against a culture of normalization for assistance programs, but we also need to fight against Medicaid fraud.
Each year, the attorney general’s office charges Ohioans with Medicaid fraud. Most of these charges are against healthcare industry workers who fraudulently claim services never rendered, or overcharge for services. Medicaid fraud in Ohio amounts to millions of dollars each year. Along with fraud is our own government corruption. Centene, the largest Medicaid care provider, settled a lawsuit with Ohio for $88.3 million for overbilling the Medicaid department thereby defrauding Ohio taxpayers of millions of dollars. And what did the state of Ohio do after the settlement? Ohio’s department of Medicaid turned around and went into contract (for billions) with Centene to create a Medicaid plan called Buckeye Health Plan. Am I missing something here???
Ohio is in trouble with Medicaid. Between expansion under Kasich, which needs to be repealed, and incentivizing/normalizing dependency on the program, along with corruption and fraud, we will have to claw our way out of the hole we are in. Are you brave enough to do that? Will you go to your state legislators and demand action? Will you go to your community and stop normalizing dependency? Each of us has a responsibility to change the culture around us, or before you know it, there will be Medicare for All.
