Politics & Policy

The Medicaid Expansion

With a "cure" like this, who needs disease?

New research predicts that Obamacare will swell America’s Medicaid population by nearly 16 million individuals. All told, health-reform legislation currently before Congress would welcome nearly one in five Americans into government-run medical welfare. Between 2010 and 2019, the Congressional Budget Office estimates, this single provision would increase state outlays by $33 billion and accelerate federal spending by $345 billion.

Interestingly enough, when the Heritage Foundation documented how Medicaid populations would grow in all 50 states, they found this phenomenon most pronounced in Nevada and Montana, the respective homes of Democrat leader Harry Reid and Finance Committee chairman Max Baucus, the Senate’s two loudest Obamacare advocates.

Heritage scholar Ed Haislmaier inspected the latest-available data in his paper titled “Does ObamaCare Turn Your State into a Medicaid Monster?” These numbers capture the Medicaid population in June 2008.

Obamacare would invite childless, non-elderly adults into Medicaid for the first time and extend benefits to those earning 133 percent of the federal poverty line: $29,326 for families of four, or $14,403 for individuals.

Obamacare’s parameters would boost the average state’s Medicaid-eligible population by 36.6 percent. Americans on Medicaid would jump 15.9 million — from 43.5 million to 59.4 million. The 14.5 percent of the nation on Medicaid today would climb to 19.9 percent.

Meanwhile, Nevada’s 188,885 on Medicaid would swell by 155,000 eligible to 343,885, an 82.1 percent increase.

“Senator Reid appears to be paying little attention to his home state, where unprecedented declines in tax revenue already have led state lawmakers to enact the largest tax hike in history — a 19 percent single-session increase,” says Geoffrey Lawrence, the Nevada Policy Research Institute’s fiscal policy analyst. “Apparently, Senator Reid does not believe that tax hike was large enough. The Medicaid expansion that Reid is ushering through the Senate as a component of Obamacare would impose an unfunded mandate on the state of Nevada that likely would require yet another round of tax hikes. The proposed 82.1 percent expansion in Nevada’s Medicaid-eligible individuals could require more than $1 billion annually in additional expenditures. Those funds would come out of new taxes on businesses and individuals that would impede job creation. With Nevada’s unemployment already at 13.3 percent and rising, it seems clear that Senator Reid has lost touch with those in his home state.

In Baucus’s Montana, the Medicaid populace would increase by 80.7 percent, from 78,068 today to 141,068 post-Obamacare.

“Montana is one of the fortunate few states to be running a surplus of about $350 to $400 million for our two-year budget cycle,” Montana Policy Institute president Carl Graham tells me. “That could be wiped out, though, if the 80 percent increase in Medicaid eligibility identified by Heritage’s study resulted in a proportionate, or $372 million, increase in state-funded Medicaid expenditures.” Graham added: “Senator Baucus should consider who he works for rather than who funds his campaigns. We’ve worked hard and sacrificed to have a sound state budget, and we don’t appreciate the federal government undermining it with unfunded mandates and special-interest payoffs.”

This Reid-Baucus Effect should worry potentially vulnerable Democratic senators. Their constituents most likely will be agitated if they support a massive Medicaid expansion that hammers state and federal finances.

‐Amid New York’s $3.1 billion deficit, Kirsten Gillibrand might reconsider endorsing a measure that would boost her state’s Medicaid cohort by 20 percent — or 829,000 — from 4,139,582 to 4,968,582.

‐Blanche Lincoln, already nervous about Obamacare, should be, since it would grow Arkansas’s Medicaid populace by 39.8 percent — or 194,000 — from 487,538 to 681,538.

‐Kent Conrad’s North Dakota constituents may grill him about legislation that would push Medicaid recipients 50.1 percent higher, from 51,890 to 77,890.

‐Will Florida’s Bill Nelson enjoy discussing the 1,162,000 new Medicaid beneficiaries — representing a 54 percent hike in Florida’s total Medicaid population — that Obamacare will add to the rolls in his state?

‐Can Michael Bennett defend legislation that would boost Colorado’s Medicaid population by 70 percent — or 285,000 — from 407,160 to 692,160?

‐House speaker Nancy Pelosi is very comfortable in her colorful, hard-left San Francisco district. Nonetheless, California voters might be intrigued to know that the Reid-Baucus Effect would hike Golden State Medicaid recipients by 2,235,000 — or 34.3 percent — from 6,524,154 to 8,759,154.

As Haislmaier told the Senate Small Business and Entrepreneurship Committee on Oct. 20, “The effects of any new federal requirement to expand Medicaid eligibility up the income scale will be not only to impose new costs on state taxpayers, but also to draw more, younger, healthier individuals out of the private-insurance pool in which small employers participate. In general, that will make private coverage more expensive for small businesses and their workers.” Haislmaier also noted that “expanding Medicaid eligibility to more lower-income workers, particularly those without dependent children, will have a destabilizing effect on the small-employer health-insurance market.”

Higher spending, tax hikes, costlier health coverage, and insurance-industry instability. With a “cure” like this, who needs disease?


— Deroy Murdock is a New York-based columnist with the Scripps Howard News Service and a media fellow with the Hoover Institution.

Deroy Murdock is a Manhattan-based Fox News contributor and a contributing editor of National Review Online, and a senior fellow with the London Center for Policy Research.

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