Indiana Gov. Mike Pence opened the week by launching a government-run state news service. Now we know why: he needs somebody to sell his “conservative” version of government-run health care.
If you think I’m being harsh, Wednesday’s White House press briefing featured a shout-out to Pence for agreeing to Obamacare’s Medicaid expansion. “We commend Gov. Pence,” President Obama’s deputy press secretary said, a kiss of death for the Republican’s 2016 presidential hopes.
That’s not how Pence sees it, of course. He is touting his Medicaid cave as free-market, conservative reform. It’s an argument he’s been previewing long before his Medicaid cave became official.
“Reforming traditional Medicaid through this kind of market-based, consumer-driven approach is essential to creating better health outcomes and curbing the dramatic growth in Medicaid spending,” Pence vowed, according to the Indianapolis Star.
Conservative buzzwords aside — “market-based, consumer-driven” — this is an expansion of Medicaid. It will lead to more people receiving government health care, at federal taxpayer expense in the short-term and likely at Indiana taxpayer expense in the long-term.
Sure, the Obama administration graciously allowed Pence to incorporate a few conservative reforms. Some beneficiaries will have to toss some dough into health savings accounts, for example. Huffington Post described it as “the biggest departure from traditional, government-run Medicaid yet.”
But the Medicare prescription-drug benefit contained some free-market elements too. Some conservative ideas were folded into No Child Left Behind. While in Congress, Pence was among the few Republicans to defy President Bush and vote against them both.
Why? Because they made the federal government bigger. The drug benefit also increased Medicare’s already substantial unfunded liabilities, making it through a Republican-controlled House largely thanks to last-minute arm-twisting and chicanery.
Democrats have worked to strip out the free-market aspects of Medicare Part D ever since. They’ve proposed drug price controls and gone after Medicare Advantage. And few would still argue that No Child Left Behind was a conservative reform.
Now Pence has made Indiana the 28th state to sign onto a version of Obamacare’s Medicaid expansion, contributing to a $920 billion price tag over the next decade. What are the odds that his plan will be pushed to the left rather than pushing traditional Medicaid to the right?
As the Washington Examiner’s Phil Klein pointed out, “the Obama administration is playing the long game, realizing that if it keeps adding beneficiaries to the books, big government liberalism wins.”
This isn’t just an ideological point. Medicaid is a terrible program that is bleeding state budgets and producing bad health care outcomes for the people its supposed to help.
Part of the latter problem is that Medicaid pays doctors only 56 percent of what private insurance does. This doesn’t magically produce better care at a lower price. It instead guarantees that fewer quality doctors will treat Medicaid patients. According to some studies, a majority of physicians don’t.
The liberal Urban Institute estimated a 42.8 percent drop in fees for primary care services this year, with a bigger decrease in states that expanded Medicaid.
Nevertheless, hospital lobbies have pushed for the Medicaid funds and Republican governors have increasingly signed on. Pence’s fellow governor and potential GOP presidential candidate John Kasich took a different approach. Instead of pretending his Medicaid plan was conservative, Kasich instead suggested Republican expansion opponents were going to hell.
It points to a bigger issue for the GOP. Most of the Republicans who have actually governed have done things that some conservatives consider to be a deal breaker. (Consider the back-and-forth over whether Scott Walker supports amnesty.)
Executive positions require more compromise than being a legislative backbencher. But some of these compromises — like helping to consolidate Obamacare — are pretty counterproductive to what conservatives are trying to accomplish by electing Republicans in the first place.
One clever headline writer tweaked Pence’s public option for the media as “Pravda on the plains.” But there are plenty of reporters for privately owned publications who are willing to rewrite government press releases. Pence’s Obamacare surrender is the real story.
W. James Antle III is managing editor of The Daily Caller and author of the book Devouring Freedom: Can Big Government Ever Be Stopped? Follow him on Twitter.