An angry reader writes on taxes and Medicaid -- July 26, 2012 column

By MARSHA MERCER

Rants from readers are nothing new to me, but one angry email recently grabbed my attention.

“Lady,” it began, “are you so rich that you don’t even realize what you are saying?”

What? The question took me aback but also made me smile. It ain’t me, babe.

Disagree with me, sure. Accuse me of spouting gibberish, if you must. But, please, don’t confuse me with the one percent. My only car is an 11-year- old Subaru. I don’t own a horse and have no clue about dressage. I buy Grey Poupon with a coupon.

But my correspondent, a woman from rural Virginia, imagined I cared nothing about higher taxes for whatever purpose, wherever they might arise, hers or mine.

“Go ahead and pay those taxes,” she wrote, “and pick up mine while you are at it.”

Her gripe was with my column last week on the Medicaid expansion under the Affordable Care Act, a.k.a. Obamacare. The law was supposed to bring 16 million people under Medicaid by expanding the program to include adults under 65 without children who are not disabled and whose income is up to 138 percent of the poverty line -- $26,344 for a family of three this year.

But Medicaid, the nation’s health care program for the poor, is a joint federal-state program in which the states set eligibility and decide which benefits will be covered. Southern states tend to be the stingiest, but under the expansion, the stingiest would benefit the most. The new law sets minimum standards that every state would meet.

In its decision last month, the Supreme Court upheld the law but essentially made the Medicaid expansion a state option. About a dozen governors, mostly in the South, are weighing whether to participate at all in the expansion. They contend the costs are too high, even though the federal government will pay 100 percent of the Medicaid expansion costs for the first three years and 90 percent after that.

I understand that it’s all taxpayers’ money, and I get it that nobody likes paying more. I’m not crazy about taxes myself. But I don’t shield my assets in offshore accounts.

I figure that compared with a lot of other things my tax dollars go for, health care is a worthy cause. It’s more humane and more cost effective in the long run for as many Americans as possible to have health insurance. The costliest care, spread among all payers of insurance premiums, is in emergency room. That drives health care costs ever higher.

Besides, it ’s not as if the choice is between expanding Medicaid and cutting taxes.

As Congress dithers about the federal deficit and whether to end the Bush era tax cuts, it’s worth remembering that much-maligned Obamacare actually lowers the federal deficit. This is not a news flash. Budget analysts have been saying so for years, but critics of Obama never believe it.

The nonpartisan and highly respected numbers crunchers at the Congressional Budget Office reaffirmed the deficit finding this week.

In a letter to House Speaker John Boehner, CBO said the latest House bill repealing Obamacare would increase the deficit by $109 billion between 2013 and 2022. That’s right, were the Republicans to succeed and kill Obamacare, the deficit would rise $109 billion by 2022.

That’s because the net savings from eliminating some of the law’s provisions would be more than offset by spending increases and decreases in revenue. Repealing the law would reduce direct spending by $890 billion, but it would also reduce revenues by $1 trillion between 2013 and 2022, CBO said. To repeat, repealing Obamacare would add $109 billion to federal deficits.

Medicare and Social Security are both in trouble with numbers that aren’t sustainable. The Affordable Care Act nibbles at Medicare costs, but we’ve not begun to work on Social Security.

We need to do more. We need to take care of each other.

“Go back and reread your column,” my reader said, “and rethink your so-called editorial.”

And so I did. Now, I’d love to hear from you and other readers about what you think we should do about health care and Social Security.

© 2012 Marsha Mercer. All rights reserved.