Medicaid Expansion: States Can’t Reverse Course


“One of their main claims, advanced by Ohio’s John Kasich and others, is that states can change their minds later. Expand Medicaid today and pocket the 100% funding Washington is dangling in front of them for a time, but include so-called “sunset” clauses that would rescind the new coverage if Medicaid proves too costly or if the feds renege on their free-money promises.”


“These supposed sunset clauses are really a roach motel. Once states check into new Medicaid, the almost certain legal reality is that they can never check out.”

“The Affordable Care Act mandated that states convert this joint state-federal program into a new, larger and far more expensive project in perpetuity. Democrats did not include any provision or opt-out clause that would let states leave new Medicaid in the future or revert to Medicaid in its old form….”

“…unfortunately for Mr. Kasich and his fellow flippers, Chief Justice John Roberts and six of his colleagues did not stipulate a right to leave Medicaid at any time…”

“…[In the case of new Medicaid,] the states can now freely take the contract as originally offered: accede to the new program, the free money and the lack of an opt-out clause.”


“…there’s no evidence in the original law or the Supreme Court opinion that states can join or leave at their own whim….”

“…”guidance” from the federal Health and Human Services Department [purports to indicate] that states “may decide later to drop the coverage.” But these informal documents on the HHS website lack the force of law…”

“’We wouldn’t be surprised if HHS is promising flexibility now only to revoke it later as a deliberate bait and switch….Republicans tempted to sign up for ObamaCare’s Medicaid expansion had better think twice because once they do, the likelihood is they’re ceding control forever.”

March 15, 2013, 6:29 p.m. ET

New Medicaid’s Roach Motel



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