By: Jim Anthony and Donald Bryson
In every state that has implemented Medicaid expansion, the costs have been substantially above projections. The expansion of Medicaid, a policy relic of Obamacare, has hit some states harder than others. California saw its expansion-related costs balloon to 278 percent above what their lawmakers projected. Even the more conservative-leaning Kentucky experienced sticker shock as they discovered their projection missed the mark by 95 percent.
There are other states, like Texas and Mississippi, that have held the line against this Leviathan of a program. Until very recently, expanding Medicaid wasn’t even on the table in a state like North Carolina. However, 2018 saw a shift in the balance of power, with Republicans losing their veto-proof majorities. State Sen. Phil Berger, the top senator in the General Assembly, is right when he says Medicaid expansion is wrong for North Carolina — and his honesty should be applauded. Medicaid expansion puts resources for the truly needy at risk, threatens a state’s budget, and disincentivizes work for able-bodied citizens.
Medicaid expansion takes a program designed to care for the elderly, disabled, low-income children, and pregnant women, among others, and opens it up to able-bodied adults in their prime working years. As a result, traditional Medicaid beneficiaries are forced to compete with able-bodied adults for limited services and providers like never before — and in reality, their new competition is a group like none other.
Medicaid expansion creates a new class of able-bodied adults dependent on welfare, the majority of whom are not working at all. Despite the myth that most Medicaid expansion enrollees are working hard, the truth is up to 70 percent of Medicaid expansion enrollees report absolutely no income. Instead of promoting work for able-bodied adults and preserving welfare resources for the truly needy, Medicaid expansion encourages this dependency and puts able-bodied adults at the front of the line for care.
The fact of the matter is, in our home state of North Carolina, able-bodied adults who would be eligible for Medicaid expansion already receive generous subsidies to purchase private insurance. The federal government fully pays for those subsidies, but if our state and others currently considering expanding Medicaid go forward with this budget sinking ship, they’ll be forced to pay for a portion of enrollees’ care instead. Where that money will come from and how much taxpayers will be forced to pay is still unknown. In states that have already expanded Medicaid, more than twice as many individuals enrolled than were projected, and the actual cost exceeded projections by a whopping 157 percent.
These massive overruns are now wreaking havoc on state budgets and many states are looking for solutions to walk back Medicaid expansion or tax their way out of the problem. In Ohio alone, nearly 280,000 more individuals enrolled in Medicaid expansion than were projected and cost overruns totaled $7.1 billion in just three and a half years. Proposals to deal with this budgetary crisis included cutting payments to pediatric hospitals and limiting eligibility for pregnant women, the elderly, and the disabled — the very populations Medicaid was designed to help.
The experiences in other states should be massive red flags for states considering Medicaid expansion. The truth is Medicaid expansion is a budget buster that states can’t afford without robbing resources from other priorities and the truly needy.
Medicaid expansion isn’t “the right thing to do,” as many have suggested. Discouraging work and creating government dependency, risking precious resources for the truly needy, and blowing state budgets — these are not American values. More policymakers across the nation need to re-read the facts and refocus their efforts to do the real right thing for their citizens by opposing (or repealing) Medicaid expansion.