With all the talk about forcing people to buy health insurance, health insurance exchanges, and high-risk pools, it is often forgotten that most of what Obamacare really is, is just a massive expansion of an existing and already failing entitlement program. Of the 34 million Americans who gain health insurance through Obamacare, over half (18 million) will receive it through Medicaid.

In its current form, Medicaid is already bankrupting states across the country. Obamacare only further overloads this already broken system by expanding Medicaid eligibility to include all Americans under 133 percent of the federal poverty level. While Obamacare will pay for all of the benefit expansion for the first three years, and 90% of it after that, Obamacare never pays for any of the state administrative costs for adding those 18 million Americans to their welfare rolls. That amounts to billions in unfunded federal mandates for states to absorb.

Worse, current Medicaid enrollees already have trouble finding doctors who will see them because, nationwide, Medicaid pays only 56% as much as private coverage does. And what state Medicaid programs do pay doctors for shrinks every day. Bloomberg reports:

Washington State may not pay for glasses anymore. Massachusetts already chopped dentures. As of Oct. 1, North Carolina no longer covers surgery for the clinically obese.

Governors nationwide are taking a scalpel to Medicaid, the jointly run state and federal health-care program for 48 million poor Americans, half of whom are children. The single biggest expense for states, Medicaid consumes about 22 percent of their total $1.6 trillion in expenditures, more than what is allocated to elementary and secondary education, according to a National Governors Association report.

In California, Governor Arnold Schwarzenegger proposed $980 million in savings on Medi-Cal, which covers 7.5 million people, after previously slicing $110 million for acupuncture, chiropractic and dental services in 2009. His Dec. 6 proposal included $100-a-day copayments for hospital stays and a limit of 10 doctor visits a year.

Arizona will reduce payments to doctors, hospitals and ambulance services by 5 percent beginning April 1, according to Monica Coury, a spokeswoman for the Arizona Health Care Cost Containment System, the Medicaid agency. … The state stopped paying for heart, liver and other transplants on Oct. 1, prompting criticism of Governor Jan Brewer, a Republican.

“We are the only state that has cut transplant care,” state Representative Anna Tovar, a Democrat from Tolleson who received a stem-cell transplant, said in a telephone interview. “Who are they to put a figure on a person’s life?”

Tovar asks a great question: “Who are they to put a figure on a person’s life?” But when the government takes over health care, which is what Obamacare’s Medicaid expansion is, putting a price on a person’s life is exactly what happens.