Burgum Nails Answer to Medicaid Question


“This isn’t a little deal this is a big deal.”

That’s what House Majority Leader Al Carlson said during a 2013 floor debate over the disastrous Obamacare law’s expansion of the state Medicaid program (video here).

“This is a door from which you walk that you’re never returning. As long as I’ve been here…we’ve been talking about how many times we’ve stopped something that we’ve started. The answer is never,” he said.

“You’re going to fund something you’ll never go back from,” he added.

Carlson was right. Obamacare’s expansion of the Medicaid program was and continues to be a big deal, part of an overall national policy which has been an abject failure.

In fact, the expansion has cropped up in the otherwise quiet gubernatorial election in 2016, because state lawmakers must decide during their 2017 session starting in January whether or not to re-authorize the expansion.

During a recent tour of the state Democrat candidates – including gubernatorial candidate Marvin Nelson – suggested that Republicans may not re-authorize the expansion. It’s worth noting that currently the feds pay 100 percent of the expansion, but starting January 1 the state will begin paying 5 percent, a figure that will go up to 10 percent in 2020.

The purpose of this post is to highlight the pitch-perfect way Nelson’s Republican opponent, Doug Burgum, responded to Democrats bringing up this issue:

Burgum said there are “many benefits” to expanded Medicaid in North Dakota, such as the 20,000 people who have health insurance. But he said it’s part of a “larger problem.”

“And it’s part of a larger problem called Obamacare,” he said before door-knocking in a Grand Forks neighborhood.

Still, Burgum signaled he was open to reauthorizing Medicaid expansion.

“This isn’t about a simple vote in the state Legislature about, ‘Do we reauthorize for another two years?’ We very well may choose to do that,” he said. “We may say that’s the best decision for right now for North Dakotans. … But when we vote to reauthorize for another two years, we will be participating in a program that’s not actuarially sound.”

Spot-on, I think.

It would be fair to criticize Burgum for taking this position after he lambasted Attorney General Wayne Stenehjem for supposedly supporting Obamacare based on some pretty flimsy grounds. Stenehjem has never supported Obamacare, and neither has Burgum.

Some might be tempted to argue that Burgum’s response is hedging. So much rhetorical cover for a cave to flawed policy, but there are practical realities to consider here.

For better or worse, lawmakers expanded the state’s Medicaid program back in 2013. Today there are thousands of people dependent on that expansion. The state is between a rock and a hard place, forced to choose between ostensible support for a national health care policy that is not “actuarially sound,” as Burgum put it, or pulling the rug out from under North Dakotans now covered by the expansion.

Obamacare is an absolute travesty. Burgum clearly recognizes that. That’s a good thing.

When he’s governor – which, all due respect to Marvin Nelson, will happen next week – he may be forced to go along with this expansion of Medicaid. But let’s hope he also continues his strong opposition to the overall policy.

I think he will.