The Magical Thinking of Medicaid Expansion (all the bad news about Obamacare)

This is pretty dramatic.

Missouri’s Governor announced last week the state will not expand Medicaid on July 1st as demanded by the voters in a ballot measure last August.  This is because Republican state lawmakers refused to fund Medicaid expansion in the most recent budget bill.  Without a revenue source or funding authority from the state legislature, the state cannot proceed with expansion at this time, the Governor said.  A court fight is expected.

The voters demanded Medicaid expansion in Missouri, but the state couldn’t figure out a sustainable way to pay for it.  Expansion would cost the state hundreds of millions of dollars a year, but nobody knew what the funding mechanism would be.

The same thing happened in Idaho and Oklahoma.  In Idaho, voters approved expansion in a referendum and the program is underway, but there is still no stable permanent funding source.  State legislators tried to stick counties with the bill.  Part of the problem is that expansion costs are way higher in Idaho than the original estimates.  Some of us warned about this, because expansion has blown up in just about every state that adopted it, and now we get to say ‘we told you so.’  Virginia is an exception so far, but only because extra COVID funding from the federal government is masking the financial fallout from enrollment being way over what they said it was going to be.

Oklahoma’s challenge is to find stable funding at a time when there is already a billion dollar budget shortfall.  Expansion cost estimates were lowballed there, too, to increase chances the voters would fall for it.  Higher hospital bills for everybody is one idea under consideration.  Another is diverting money from the tobacco settlement already slated for other uses.

If you look at Medicaid expansion overall, you find that enrollment is more than double on average in expansion states than originally estimated.  States have hit the wall financially because of it.  About the craziest idea for funding Medicaid expansion comes out of Kansas where the Governor would pay for it with marijuana taxes.

I don’t know what’s worse: the Left’s magical thinking that you can just wish expensive programs into existence without having any way to pay for them, or the complete irresponsibility of everyone who played along.  An exercise in good government this is not.  Remember that the next time mindless liberals and their politician friends want to create new programs and grow the government.

– legalize true catastrophic insurance
– return Medicaid to a poverty program


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