Repealing Obamacare’s Disastrous Medicaid Expansion

If something is dysfunctional – especially a government program – it only becomes a larger problem when you expand it without first reforming it.  Expansion of a program doesn’t automatically make the program work.

That is precisely what the Obama administration, most Democrats in Congress and a handful of Republican governors have done with  Medicaid under Obamacare, though.  It is a broken, flawed program, and they have expanded it, making it an even bigger problem than before.

That is why the first piece of legislation Rep. Matt Salmon (R-AZ) has introduced in the 113th Congress is The Medicaid Expansion Repeal and State Flexibility Act (H.R. 1404).

This is something that anyone who opposed Obamacare should support.  Obamacare’s Medicaid expansion would be a massive strain on the economy, especially the States’ economies.  As Rep. Salmon explained in a press release:

One of the big-ticket items included in Obamacare was a provision that essentially bribed states to expand their Medicaid eligibility requirements to 138% of the poverty level, and to have the Federal government pay for 100% of the expansion.  As with most other aspects of Obamacare, unwanted strings are attached.

Obamacare only covers the full cost of this expansion for the initial years, but leaves the onerous federal mandates to stay.

Conservatives are in favor of helping those truly in need and truly vulnerable until they can achieve a position of independence.  However, with Obamacare’s Medicaid expansion, individuals living at 138 percent of the federal poverty level, many of whom are a “population of able-bodied adults” and “the vast majority of whom are single without dependents.”

There are better options than allowing this coercive Medicaid expansion to be implemented.  Instead, the States should be given maximum flexibility to provide services to their most vulnerable populations.

As the law currently stands, states have the option to block the coercive intrusion by the federal government to adopt the Medicaid expansion.  But many States have fallen for the temptation of what seems to be “free money.”

But nothing is free.

As the Heritage Foundation has warned, the States will pay dearly for this in the long run, and by entering into the Medicaid expansion, they are likely putting their budgets at a great risk in the future.  Governors who adopt the Medicaid expansion lack foresight, as they fall for the temporary and apparent gain of having the federal government pay for the expansion:

Over time… in the majority of states, Medicaid spending will accelerate and dwarf any projected uncompensated care savings

Rep. Salmon’s legislation would repeal the Medicaid expansion in order to allow governors to adopt better policies within their respective States.  Anything less will be damaging to the economy and a detriment to taxpayers and patients alike.  Indeed, one-third of doctors nationwide are not accepting new Medicaid patients because the government doesn’t pay enough to cover the cost of treating them.  And while Obamacare trickily attempts to remedy this problem by increasing Medicaid payment rates for primary care to match those of Medicare, those pay increases are temporary:

After 2014, either Medicaid physicians will take a huge pay cut or taxpayers will be asked to step up and maintain the increased rates.

If States fall for this disingenuous maneuver, they’ll have the rug pulled out from under them.  Conservatives have seen this game before; we understand it is not a good deal; and we know the States can take another path.

The better path is conservative reform that would put patients first, the details of which can be found here.



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