During a $250 a plate luncheon on March 19th in Natchitoches, Louisiana, U.S. Rep. Ralph Abraham (R- LA-05) claimed that rising healthcare costs are the result of the economically disadvantaged caring more about “voting for a living instead of working for a living,” according to an audio recording provided exclusively to the Bayou Brief.
Abraham, a medical doctor who ran a rural clinic in Mangham, Louisiana prior to his election to Congress, had been fielding questions during a fundraiser for his gubernatorial campaign when a supporter asserted an elaborate conspiracy theory as if it were fact, telling Abraham that $150 million of the $800 million spent on Medicaid expansion in Louisiana was “waste, fraud, and abuse.” Both of those numbers are wildly inaccurate, and neither were corrected by the congressman, who instead rambled extemporaneously for three minutes about healthcare policy and struggled to get basic facts right.
At one point, Abraham falsely claimed that Medicaid expansion resulted in people being forced to relinquish their employer-provided private insurance plans. “They were mandated to go to the expansion,” Abraham asserted. The program does no such thing.
At another point, he conflated the Emergency Medical Treatment and Labor Act (EMTALA), which was signed into law in 1986 by Ronald Reagan, with the Patient Protection and Affordable Care Act, the landmark 2010 law often derided by conservatives as Obamacare.
In an effort at diagnosing the problem, the doctor misidentified the symptoms and instead shifted the blame for the escalating costs of healthcare on the working poor in comments that echo similar remarks also made at a closed door fundraiser by presidential candidate Mitt Romney in 2012.
“I’m just tired of people voting for a living instead of working for a living,” Abraham said, “because if they’re on that program of the government- and it could be a state or a federal program- what are they going to do? They’re going to vote to keep that program going.”
That day, the Associated Press reported the U.S. Centers for Medicare and Medicaid, better known as CMS, had decided to place Louisiana on a review, in response to questionable findings by legislative auditor Daryl Purpera which suggested between $61.6 million to $85.5 million had been spent over 20 months to provide health insurance through Medicaid to individuals and families who exceeded the income thresholds.
Purpera’s analysis, however, is fatally flawed.
For whatever reason, he only looked at a sampling of 100 supposedly random recipients. Currently, there are nearly 500,000 Louisianians who have qualified for coverage under Medicaid expansion. Purpera’s sample, even assuming a 95% level of confidence, would have a margin of error of 10%, and it is impossible to accurately extrapolate anything conclusive about total spending given such a massive deviation.
Moreover, unlike every other state, Louisiana had been allowed to qualify coverage for those whose annual income was proven to be no more than 25% higher than typically allowed, a vestige of an agreement signed under the Jindal administration in order to ensure compliance and avoid massive losses in federal funding. Most states allow applicants to qualify if their income is within 10% of the threshold, and Louisiana has subsequently changed its guidelines and implemented a monitoring system that has won praise by CMS.
This is not the first time Rep. Abraham has demonstrated his fundamental misapprehension of government spending and programs. After an appearance at the Baton Rouge Press Club in February of 2018, The Advocate‘s Lanny Keller penned a blistering column titled “Out of touch, lacking ideas, congressman shows he’s not ready for prime time.”
No other district in Louisiana has benefitted from Medicaid expansion as much as his. Abraham’s district, LA-05, is the tenth poorest in the nation, and as a direct consequence of Medicaid expansion, it has seen double-digit increases in the percentage of residents with health insurance.
The congressman isn’t not just ready for “prime time;” apparently, he’s not even ready for lunch time.