Get ready for some major squabbling in the 2015 Montana Legislature over public preschool and Medicaid expansion.
Many states already have pre-kindergarten programs, but Montana does not. However, some school districts offer pre-K, while the federal government already offers Head Start, targeted at disadvantaged kids who clearly would be better off at school rather than at home.
For parents willing and able to pay the freight, Montana also offers private preschool and daycare. But some are upset because no “accreditation standards” regulate preschools in Montana (like one needs a degree to raise a kid properly?). So Gov. Steve Bullock, apparently taking his cue from Common Core and President Barack Obama’s State of the Union call for federal funding of universal pre-school, is proposing universal, voluntary pre-K, called “Early Edge.”
The claim is, state pre-K won’t raise taxes because the initial $37 million a year ($3,000 per student) will come out of the general fund pool – in other words, diverted from other general-fund programs. Might those programs be more important state-government functions than providing nursery school? Depends on who you ask – but on Sept. 16, 2014, the interim Education and Local Government committee narrowly voted 6-5 not to support Early Edge.
Get the popcorn.
Then there’s a leftover from the 2013 session: Medicaid expansion.
Originally, Obamacare mandated Medicaid expansion to persons making 138 percent or less of the state poverty level, but the Supreme Court made the mandate optional – states can choose to keep their old program and not lose existing Medicaid funding. You know, if states like it, they keep it?
On the surface, the deal seems sweet: Expansion would be initially funded with up to $1.6 billion a year of federal money. Eventually a 10 percent state “co-pay” of around $160 million a year would phase in by 2021. Roughly 70,000 more low-income Montanans would qualify for “free” government health care, and 17,000 more health care workers would be hired.
The Montana Hospital Association supports expansion, for good reason. Currently, healthcare providers are finding themselves on the hook – writing off uncompensated, unpaid-for costs of $244.9 million. The billing for that care is, however, $401.6 million.
The Service Employees International Union Healthcare division supports expansion as well, as more jobs mean more union members.
After much sturm und drang, expansion failed “narrowly” in 2013’s Legislature. Montana’s “leftstablishment” followed up with a ballot initiative attempt, failing to gather enough signatures.
So, here it goes again. I waded into a University of Montana Bureau of Business and Economic Research (BBER) report done for the state auditor’s office, seeking nitty-gritty numbers on expansion. It’s actually pretty honest, full of interesting stuff:
In liberal states, 61 percent of Medicaid-qualified enrollees sign up (ultra blue Massachusetts is at 85 percent). In conservative states, only 54 percent do. What does that imply about “free stuff” that isn’t, and voting habits?
In terms of economic impact, BBER figured 14,400 jobs by 2021 ($636 million, average wage of $42,000) with $197 million going back in taxes to the state and federal governments – all this prosperity from a “flow of new federal dollars into the economy.”
While the wages seem fat, I found myself flashing back to overpaid Obamacare swami John Gruber’s discussion of the “stupidity of the American voter.” Come on, where do new federal dollars come from?
And here’s where it really starts to get thick. “Childless adults” are expected to make up most of the new qualifieds, and they are “typically less likely to enroll.” With that in mind, the BBER people concluded the higher-cost scenario would run $406 million per year, plus six percent in overhead – not so terrible compared to $1.6 billion a year.
But at the individual level, BBER found that if expansion happens, and the expected persons enroll – per member Medicaid costs of non-disabled adults in Montana will run $9,504 per year.
Again, we’re talking non-disabled, likely childless grownups – for a two-person household enrolled, their combined gross wages could be $21,000 or so – against $19,008 in Medicaid? A single, making $16,000 or so, getting $9,504?
Well, I’m sure some legislators will ask what the heck … please, more popcorn, with butter.