When our oh so august and Democratic bureaucrats were originally formulating the, ahem, Patient “Protection” and “Affordable” Care Act, the plan was to get all of the states to expand their Medicaid coverage qualifications so that all residents earning less than 138 percent of the federal poverty line would become eligible. Getting the states to cooperate to help them pay for the major expansion of one of America’s biggest and most debt-fueled entitlement programs was one of the law’s key provisions, but unfortunately for the Obama administration’s best laid plans, the Supreme Court ruled last year that individual states could preserve the option to not participate in the expansion.
To entice the states to do so voluntarily, the revised expansion program shifts 100 percent of the costs for new enrollees onto the federal government for the first three years, and then the federal match rate will taper down to 90 percent by the end of the decade — but so far, only 23 states and the District of Columbia have decisively taken the bait.
At least 21 states are opting out of Medicaid expansion for next year. In another six states, legislators are still weighing their options, according to the Kaiser Family Foundation, which is tracking the states’ plans. …
A number of governors, particularly in red states, have stood their ideological ground and chosen not to expand, citing concerns about the additional financial burden. The federal government will pay for 100% of the expansion for the first three years, then gradually reduce its subsidy to 90% by 2020.
Some governors have said that expansion would involve additional costs that they couldn’t afford and enlarge a program that they consider broken. In many states, however, various analyses show that states would stand to gain millions of dollars by expanding the program, at least initially.
Yes, initially states might save millions by taking “free money” from our $17-trillion-in-debt federal government, but that little stopgap won’t last forever and states are worried about being plunged ever further into debt by a broken and ineffective program.
Texas has been a leader in resisting the federal government’s advances, admonitions, and pleas for Medicaid expansion, but as the most populous state after California and amidst all of ObamaCare’s implementation struggles, the Obama administration would really appreciate it if Texas would please just do them a solid and abandon their so very heartless and stubborn crusade of big-government defiance:
Health and Human Services Secretary Kathleen Sebelius today held out hope that Texas would reconsider its decision not to expand its Medicaid program.
“We are still hopeful that the decision about Medicaid can continue to be looked at because the return on investment for Texas is huge — about $90 billion in federal money that could come into the state to help some of the poorest uninsured Texans take advantage of coverage,” she said in an interview. …
“We’re building that kind of partnership in cities across this country so that they will be the ones to carry the information to their communities —- here’s what can happen, here’s what kind of help is available. That’s the way to drill through the noise about the back and forth political information and get real information to people on the ground.”
Something tells me that Gov. Perry isn’t going to be convinced.