His charge that it would drive up private insurance costs does not make sense. On the contrary, it is the current situation without the expansion that drives up private insurance costs.

The patients we are talking about do not have insurance coverage because they make too little to afford private coverage, their employer doesn’t provide it, and they make too much money to qualify for Medicaid. As a result, at present either (a) they receive charity care — and too often expensive emergency room care — that is not being paid for by the patient but rather are costs that are taken on by providers and passed on to those with insurance; (b) they are billed directly for their care, and may or may not be able to pay (right away), so again the cost is passed on (at least in part or for a period) while the patient often struggles with tremendous debt obligations or bankruptcy, or; (c) they don’t receive any care, the costs of which to them and society are incredible.

Medicaid expansion would not only insure that providers would receive payment for services, but that payment would be at the least be guaranteed and relatively timely and for a assured amount — unlikely the current situation with these patients. This is in addition to the fact that patients would be more likely to actually receive the care that they need, which is not only better for them, but for the costs of the system because it would less likely be more expensive emergency room care or delayed care. It’s a win-win.

While it may be true that Medicaid generally may pay less than some private insurers for the same care — which could mean that the difference between the payment and the actual cost could be passed on — this is less an argument against Medicaid (since the alternative isn’t being paid more but rather being paid nothing or very little), but rather an argument to fund Medicaid properly so it reimburses providers fully.

Mr. Thompson is either ignorant or being disingenuous in his statement.