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Medicaid expansion rejected by many states despite Obamacare

While many liberals viewed the decision by the Supreme Court to uphold key components of the Affordable Care Act in June 2012, as a victory for many Americans without insurance, some states are now blocking efforts by the Federal Government to for Medicaid expansion. Medicaid  is the public health insurance program for low-income families.


What did the Supreme Court say about Medicaid expansion?


While the Patient and Protection Affordable Care Act was passed in 2010 and expected to expand Medicaid eligibility to all qualifying Americans nationwide, the Supreme Court ruled in 2012 that the states could not be forced by the Federal Government to expand Medicaid. Now it is left up to the states to decide. As of now, 23 states and the District of Columbia have approved the expansion, 21 have failed to move forward, and 6 are still debating the issue.

Who Could Benefit From The Medicaid Expansion?


While it sounds like a good plan- increasing the number of low income Americans who are insured, many states have questioned whether or not it’s a financial sound decision for their state. Obamacare promised Medicaid expansion to all non-elderly individuals with family incomes below 138 percent of the federal poverty level, but now the real question is who is going to pay for it? The Federal Government has vowed to fund the cost of the increase 100% from 2014-2016. After that it is up to the states to pick up a percentage of the bill.

What proponents of expansion won’t tell you is Medicaid already eats up a huge share of state’s budgets. For instance, in Texas, more than 20 percent of the state budget is already spent on Medicaid, contributing to an estimated $25 billion deficit for the next two-year budget cycle.

Medicaid expansion in some states will be devastating, and according to the Heritage Foundation, “Obamacare does not pay for any of the costs necessary to administer the expansion of the Medicaid rolls, rolls that are expected to increase by approximately 50 percent in states like Nevada, Oregon, and Texas.” It is estimated that just the administrative cost to expand the Medicaid program in Texas could be as high as $12 billion by 2020. Texas estimates that if they do choose to expand Medicaid it could cost up to $27 billion in a single decade.

Texas says no to Medicaid expansion


As of now, Texas Republicans have vowed to stand strong against Medicaid expansion and what they consider as a fiscal time bomb set to explode their state balance sheet. Recent proposals in Texas state Medicaid "may only provide medical assistance to a person who would have been otherwise eligible for medical assistance or for whom federal matching funds were available under the eligibility criteria for medical assistance in effect on December 31, 2013."

Governor Perry’s opponents have called on him to drop his opposition to expanding Medicaid in the state of Texas. But others have hailed his decision and encourage him to remain true to his ideals of small, limited government, which does not constitutionally have the responsibility to provide health insurance to individuals.

One thing we can all agree on is the Affordable Care Act will look drastically different from one part of the country to another. It is yet to be seen whether or not the liberal states will be able to survive as Medicaid enrollees strain existing healthcare systems or whether or not the additional federal payments would ideally allow services to adapt and grow.
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