ObamaCare’s Medicaid Expansion is a Bad Deal for States
Medicaid is the single largest component of state expenditures, accounting for 23.5 percent of the $1.7 trillion spent by states in 2013.
Largely as a consequence of the ACA, state and local spending for Medicaid is projected to nearly double over the next decade.
where will the money come from?
what agencies/departments/programs will absorb that cost?
Hmmm. It looks like you might be bitterly clinging to the notion that state government should be maintaining highways and bridges and things like that.
well I did take a toll road to work this morning, so I’m trying to keep an open mind.
I want to remind everyone of one of his other blog posts! I just remember the data on how much money taxpayers have lost in funding failed exchanges.
The problem is that Medicaid is seen as an economic development tool by states. Hospitals especially think they stand to gain revenue. But, history has shown that Medicaid gradually crowds-out private coverage. Hospitals and doctors will ultimately find they are treating more Medicaid patients at the expense of privately-insured patients. A better solution is to allow the near-poor earning just about the poverty level to get (highly-subsidized) private coverage in the exchanges. States will be in a better position to ask for a block grant in 2017 to care for those earing less than the Federal Poverty Level.
Devon is correct that allowing the near poor to join the exchanges would be the best solution.
Well, a man from Mars (or perhaps Scandinavia) might ask why this did not happen after the Roberts decision in 2012.
The Obama administration had no energy to propose it, and the House Republican were passing one or more of their 40+ repeal bills. The chance for a conference committee to correct the ACA was considered nil.
And it could not have an easy task. As Chris Conover has noted, the states which did expand Medicaid would have felt cheated if the non-expanding states could have slid their people into the exchanges. Even smart persons like Chris and Joe Antos have not put forward clear solutions.
I would advance one comment of my own, as follows.
The stingy states (mainly in the Deep South) kept Medicaid eligibility under 100% of poverty for years. And single persons without children were categorically denied. I believe that an income of $7,000 kept one off of Medicaid in Mississippi.
Well, if this kind of state has to include more poor people in Medicaid, in terms of enforcing the old laws, and with a 60% or more federal match, I do not feel one millisecond of sympathy that state. In fact shame on them for the racism that in most cases was operational.