States losing billions in refusing to expand Medicaid, report finds
Dec. 5, 2013 at 12:18 PM ET
Texas will lose $9.2 billion in 2022; Florida says goodbye to $5 billion; Georgia is out $4.9 billion. A new report details just how much states are losing because they don’t want to expand Medicaid under Obamacare, and it’s not chump change.
Red states may be sticking to their Republican beliefs in small government, but the Commonwealth Fund finds they are passing up billions in federal funding by saying no to the Medicaid expansion.
“By choosing not to participate, Texas, for example, will forgo an estimated $9.58 billion in federal funding in 2022. Taking into account federal taxes paid by Texas residents, the net cost to taxpayers in the state in 2022 will be more than $9.2 billion,” the report by Sherry Glied and Stephanie Ma of New York University says.
“We find that the Medicaid expansion will be a relatively large source of federal revenue to state enterprises," the report adds. States expanding Medicaid will get, on average, more than twice as much in federal funding than they get in federal highway funds, they said.
It’s the latest report on what Medicaid expansion would mean on a fiscal level to states, and the timing couldn’t be better for the administration of President Barack Obama. The White House has launched a three-week drive to highlight what it says are the benefits of the 2010 Affordable Care Act, and Obama has been urging states to expand Medicaid.
The ACA was designed to transform health care in the United States, which most experts agree currently costs too much and leaves far too many people without health insurance. One way to do that is through the health insurance exchanges, where people can buy private insurance and which are dominating the headlines now.
The other way was by requiring states to extend Medicaid to people earning up to about 138 percent of the federal poverty level, or about $14,800 for single people and $31,000 for a family of four.
Medicaid is usually a cost-sharing program – the federal government pays on average about 57 percent of costs and states pay the rest. But under the expansion, the federal government will pay 100 percent of the additional costs for the first three years. States will have to kick in a very small percentage more each year after that. By 2020, the federal government will pay 90 percent of the costs.
But after a series of challenges to the law, the U.S. Supreme Court ruled in 2012 that the Medicaid expansion requirement went too far. States can’t be forced to add more people to Medicaid, the court ruled.
Many Republican-led states immediately said they would not be expanding Medicaid.
“As of November 2013, 20 states have decided to opt out of the Medicaid expansion,” the report said.
Glied and Ma calculated how much this would cost by 2022, and took into account states’ arguments about the so-called woodwork effect – the argument that people who were already eligible for Medicaid but had not applied would do so if they heard about the expansion. These people would still cost states the 43 percent or so of state contributions to Medicaid.
This is only one of many Federal freebies Gov. Perry has refused costing the state billions of dollars, and depriving Texas citizens of much needed care in many arenas. Meanwhile, the sociopathic Governor who has no guiding principles except his own glorification has racked up $15.5 billion dollars to add to the State's already enormous debt. Interesting considering the Tea Party platform calls for an end to deficit spending. Texas, a large and productive state, has the 10th largest economy in the world, but ranks 49th in spending for education per student. Does that make sense to anyone? His platform is to demonstrate he can say NO to Obama to garner support from the anti-federal crowd and increase his chances to be the Tea Party candidate for President. The welfare of the people of Texas is not even on his list of priorities, which is typical of a sociopath. His delusional beliefs"don't believe in global warming"; "don't believe in global climactic change"; and "don't believe the drought presents and danger to Austin"---and his resulting non-management (including aggressive suppression of conservation) have left this great city with only 6 months of water. Too late now for even a surprise weather change, like an El Nino, to save the city. It is also clear there will be no warning, and the 1.7 million residents will awaken one day in the near future and find that they have no water or power. The resulting anarchy will be as ugly as you can imagine; and thousands will die during a panicked migration of 90+ % of the population. Don't believe me? Just go to the official State web site: NCRA (North Colorado River Authority) and look at the statement that the two reservoirs, which are Travis County's only source of water, which states that the combined total is 37% full. Then look at Lake Travis which is an empty pit and has been so for over 18 months. That represents roughly half the reserve water. It ain't there. Replinishment for 2013 has been about 13% of average (the record low, in 2011, was 11%. Even October, which for Austin was the wettest October on record, had only 41% of normal inflows. The populous found the record rainfall reassuring, but having lost their ability to do critical thinking as predicted by Marshall McCluhan in c.1960 as one of the damaging effect of television, no one looks at the numbers. Therefore, there is no preparation for the anarchy by any level of government or NGO. It is even too late now to organize an orderly migration even if some organization wanted to do it. But the thought of a possible anarchy is like the water in Lake Travis---it just isn't there.