One of the best kept dirty little secrets of Obamacare is that over half of the health insurance expansion obtained by Americans through the bill is accomplished by putting them on the welfare program Medicaid. Rep. Pete Roskam (R-IL) not only made this point yesterday, but also highlighted a great quote from Gov. Brian Schweitzer (D-MT) on why Medicaid is “one of least effective programs in terms of health care in the history of the country.” From the Blair House health summit transcript:

And I think one of the problems, to get to this coverage issue, is that the premise of this bill is that coverage is expanded through Medicaid, welfare. Speaker Pelosi a couple of minutes ago — or a couple of hours ago, actually said that health care reform is entitlement reform.

SPEAKER PELOSI: Yes.

REPRESENTATIVE ROSKAM: Yes. I would put a brighter light on that and say it’s entitlement expansion. Think about what we’re doing. The CBO when they wrote to Harry Reid — wrote to Senator Reid a couple of months ago, they said, look, there’s about 15 million people that are going to be put on Medicaid. And Medicaid is a house of cards. Medicaid is not something that is serving the public very well.

The state controller in Illinois — and we all come from states with real trauma — the state controller in Illinois recently wrote that as bond rating agencies continue to downgrade Illinois rankings to the lowest in the nation, the state can’t afford further jeopardizing.

This bill, section 2001 of the Senate bill, takes away all of the flexibility as it relates to changes in Medicaid. That is making our states I think ultimately hidebound in how they approach these things. This is something that in my view isn’t sustainable.

Governor Brian Schweitzer of Montana said — let me give you a quick quote — “One of the least effective programs in terms of health care in the history of the country is called Medicaid. About 20 percent of America is on a Medicaid program and they would like to shift” — “they” meaning Washington — “would like to shift it and grow it to somewhere around 25 or 30 percent.”

Now, Medicaid is a system that isn’t working. Almost everyone agrees. But what Congress intends to do is to increase the number of people on Medicaid so that they can do it on the cheap. It isn’t working for anybody.

Look, the foundation of the expansion is Medicaid. And in my view, and I think the view of folks in my district and I think many, many people across America, it is a flawed foundation. And we can do much, much better. A Republican proposal that’s out there would reduce the number of uninsured by 3 million people.

So, look, you heard it today in many, many forms — this — you remember the old — in closing, you remember the old game you used to play as a kid, Etch A Sketch, and you’d start out with the Etch A Sketch, that little thing where you try and draw something and you dial the dials and over a period of time the more you dialed the more crazy it looked and then finally you’d say, oh, let’s just go like that and do the Etch A Sketch.

I’ll tell you what, a year’s worth of work and this is what has come up with? The American public, as far as the ones that I have heard from, are vehemently opposed to this. And they say, look, take the Etch A Sketch, go like this, let’s start over, let’s do incremental things where there’s common ground. I yield back.