It is easy to forget the overriding premise behind Obamacare: too many Americans were uninsured, unable to afford basic medical care and prescriptions. Obamacare was needed, its supporters said, because it would swiftly bring 30 million people into the rolls of the insured by making insurance affordable.

With the benefit of hindsight, we now understand that it never was about liberating those 30 million by granting them affordable insurance options. The heart of Obamacare was about providing more free insurance coverage by expanding Medicaid in the states through a massive federal entitlement.

Barack Obama and his surrogates artfully distracted awareness of the Medicaid scheme by focusing on the narrative that folks already insured had no reason to fear Obamacare, whatsoever.

Americans soon realized this pledge was fundamentally dishonest. You could keep your plan and your doctor as long as you were willing (and able) to pay dramatically higher annual premiums and jaw-dropping deductibles.

A friend’s wife, self-employed here in Moore County, insured by Blue Cross Blue Shield, has seen her premiums double during the past three years, and her deductible rocketed to $7,500.  She has received notification that her premium will rise by 22% next year. Another friend’s son, facing a $5,000 deductible, resorted to online research and self-diagnosed a kidney stone. He let nature run its course, reasoning it would be less painful than a financial setback.

North Carolina ranks second among states whose citizens pay the highest average monthly premiums in 2017 in a recent report by USA Today. The report cited data gathered by the U.S. Department of Health and Human Services (HHS). It calculated premiums assuming the purchase through an Obamacare exchange of a second-lowest cost “silver” plan by a 27-year-old. That individual in North Carolina is paying a premium of $446 per month, $5,352 per year.

It became all too apparent that meticulous word-crafting during the Obamacare sell-in did not improve healthcare options for those who actually lacked options. And while the media focused on the supposed magic of Obamacare, and on how it would positively impact so many lives, reality soon played out much differently. The Affordable Care Act was never anything more than a ploy to expand who would be eligible to be covered under Medicaid (a decades-old entitlement) across states adopting the expansion deal.

By expanding eligibility for Medicaid, Obamacare systematically turned lawmakers in one state after another into entitlement crack addicts, so that when a Republican-controlled Congress set about to “repeal and replace” it discovered that the will to do so is restrained by all of the federal dollars pouring into state-maintained Medicaid programs.

Healthcare author Bruce Japsen explained why Medicaid expansion is at the heart of Obamacare in a recent piece for Forbes. Japsen notes in particular that Kansas and North Carolina are moving toward joining 31 other states, and the District of Columbia, aboard the expansion gravy train to partake in “generous federal funding available under the law”.

Between 2014 and 2016, Medicaid expansion costs were 100% paid by federal funds. This, of course, set the stage for long-term addiction. Why? Because, writes Japsen, “the federal government still picks up 90% or more … through 2020” which makes Obamacare “a better deal” than the previous Medicaid funding formula, which was “a much less generous split between state and federal tax dollars.”

Last spring, four state republicans in Raleigh presented a plan to expand Medicaid with strings attached. Hospitals and recipients would help pay for it, along with the federal government. They said their plan would require new recipients to be employed and undergo preventive care such as mammograms and colonoscopies.

If Republicans in state houses and in Washington fail to demonstrate how reducing and eventually capping the growth of federal Medicaid payments is the fiscally responsible path going forward, there will be no daylight between them and the radical left, which always chooses ideology over security, and permanent entitlements over fiscal integrity.

The tragedy that will be at the feet of Republicans if healthcare reform fails? Medicaid will keep expanding unsustainably. Meanwhile, Medicaid ineligibles’ premiums and deductibles will escalate, and affordable options will dwindle because insurers continue to drop out of the exchanges.

Obamacare’s devious intent to hook state legislators on free Medicaid denies millions of Americans liberty, the liberty of choice in healthcare. It denies them security, the security of knowing they can afford to be treated when a serious condition arises. And it denies them opportunity, the opportunity to direct hard-earned money to future prosperity rather than onerous premium increases and Obamacare-imposed taxes today.

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