• The Heritage Network
    • Resize:
    • A
    • A
    • A
  • Donate
  • Does Obamacare Turn Your State into a Medicaid Monster?

    Each of the health care bills moving through Congress expands Medicaid by making the government-run program available to all adults with incomes at or below 133 percent of the federal poverty line (PVL). The change would dramatically multiply eligible recipients: 33 states would see increases of at least 30%, including 10 posting jumps of 50% or more.

    Fastest-growing Medicaid monsters?  Nevada (82.1%), Montana (80.7%) and Texas (76.9%), as this chart shows:

    Go here to see a larger, printable PDF of the chart.

    Heritage fellow Dennis Smith explained:

    Just hours after the Senate Finance Committee completed its mark-up of its version of health care reform, Committee staff released a statement that announced, “[i]n a letter sent to Congressional leaders yesterday, Democratic governors affirmed their shared commitment to expanding health care coverage to millions of low-income Americans through the Medicaid program.”

    Worried Governors
    The press release, however, overstates the case. The Democratic governors’ letter does not even mention Medicaid. The very general sentiments expressed in the letter such as “… the status quo is no longer an option …” and “[s]kyrocketing health care costs hurt families …” are broadly if not universally shared. Democratic governors from 21 states signed the letter; eight of them will be out of office before the Medicaid expansion even begins.

    One  governor who did not sign the letter, Tennessee ‘s Phil Bredesen, warns: “I can’t think of a worse time for this bill to be coming. I’d love to see it happen. But nobody’s going to put their state into bankruptcy or their education system in the tank for it.”

    Tying State Hands
    The letter was also produced before the Committee completed its amendment process and before a final score by the Congressional Budget Office (CBO).  Amendments will reduce state flexibility in the management of Medicaid. States lost flexibility in designing their benchmark plans.

    States will be required to extend “spousal impoverishment” rules, which apply when one spouse is in a nursing home, to community settings as well — which will substantially shift costs from private pay to Medicaid. States will be faced with a new, broader definition of medical assistance, the implications of which will be determined through regulation and litigation. The Finance Committee is turning the SCHIP children’s health program into Medicaid. CBO has not yet calculated how much it will cost the states in administrative changes that will be required to comply with the new federal mandates.

    Higher State Costs
    Medicaid programs will be forced to absorb open-ended costs in the foster care system. In adopting the Stabenow Amendment on therapeutic foster care, the Committee is now on record to overturn litigation won by the state of California to limit Medicaid’s role in funding the child welfare system. California prevailed in part because there is no agreed upon definition of therapeutic foster care. While it is required to provide services, it is not required to “bundle” those services as a package.

    The Federal Court of Appeals for the 9th Circuit determined that states still have administrative discretion in how to run their Medicaid programs. The Stabenow Amendment takes one more step towardstaking that authority away.

    The wide-open language of Stabenow will likely cost states billions as providers will seek to tap into the Medicaid entitlement to fund the child welfare system, which is really what the California litigation was about. Of course the child welfare system must be adequately funded, just as education, child care programs and the criminal justice system must be — to name a few other government programs that are trying to tap into Medicaid.

    But should these responsibilities fall to Medicaid? Finance has jurisdiction over the foster care system. But instead of facing its responsibilities in the program, it was apparently easier for senators to push the issue back onto the states’ Medicaid program. Why have schools turned to Medicaid for funding for special needs children? Because Congress has never fulfilled the promises made under the Individuals with Disabilities Education Act (IDEA). Medicaid has become an enabler. Washington promises more then passes the bill to the states.

    Medicaid Expansion
    States cannot afford a Medicaid expansion and neither can the federal government. The Finance Committee plan includes extra federal funds to pay for most of the new costs and when the bill gets to the Senate floor, Senators will try to get 100 percent federal funding just as Majority Leader Reid has done for Nevada. But simply adding more federal funds into an unreformed Medicaid program is not the answer either.

    One day perhaps, Congress will realize that expanding Medicaid comes at the expense of other state and federal priorities including education and the child welfare system. As Medicaid grows, funding for other programs shrink, which in turn, increases demand for Medicaid to become the source of funding for those other programs. Only the governors have the clout to push back and break the vicious cycle that, as Gov. Bredesen warns, threatens to bankrupt the states.

    Posted in Obamacare [slideshow_deploy]

    6 Responses to Does Obamacare Turn Your State into a Medicaid Monster?

    1. sandy arizona says:

      Have you been informed of the tax scam in the first time home buyer tax credit. Already it is littered with fraud and theft. one home buyer received 33 credits worth more than $233.000 according to search warrants. There have been no arrests. What do you think will happen to health care? Fraud and theft of course. Are we certain Obama is up to the task.

      I understand we continue to give foreign aid even though Pakistan lost billions of our aid funds.

      Congress is busy working 2 days a week I am told. Who is watching the budget? What is happening to our Country? Don't Americans deserve accountability?

    2. Pingback: Dirty Democrats » Trivia Tidbit of the Day: Part 672 — Medicaid Expansion.

    3. FLR says:

      If ever I wanted to wish my life away at 52 years of age, I wish for 2010 and 2012. I hope it will not be to late. I know people that have voted for Obama and now would like to kick themselves right in the, where the sun don't shine. 2012 is the year for this Great Country to Shine again. God Bless America

    4. Pingback: Morning Bell: It’s All Downhill From Here | Conservative Principles Now

    5. GLK says:

      They're going to make purchasing health insurance mandatory? Ha! Desoite the "law" they can't even make everyone own car insurance. Except of course the Sheeple who comprise the rapidly diminishing middle class.

    6. ShermanOakslife says:

      88 million seniors are coming, 50% of all seniors in nursing homes are on Medicaid. How do you plan to pay for them?

    Comments are subject to approval and moderation. We remind everyone that The Heritage Foundation promotes a civil society where ideas and debate flourish. Please be respectful of each other and the subjects of any criticism. While we may not always agree on policy, we should all agree that being appropriately informed is everyone's intention visiting this site. Profanity, lewdness, personal attacks, and other forms of incivility will not be tolerated. Please keep your thoughts brief and avoid ALL CAPS. While we respect your first amendment rights, we are obligated to our readers to maintain these standards. Thanks for joining the conversation.

    Big Government Is NOT the Answer

    Your tax dollars are being spent on programs that we really don't need.

    I Agree I Disagree ×

    Get Heritage In Your Inbox — FREE!

    Heritage Foundation e-mails keep you updated on the ongoing policy battles in Washington and around the country.