Is Medicaid Expansion Good for the States?
Though the Supreme Court upheld most of President Obama's Patient Protection and Affordable Care Act, it did strike down a key provision in healthcare law's expansion of Medicaid. Under the original legislation, Medicaid—the joint state-federal government health insurance program for lower-income Americans—would be expanded to cover those making 133 percent of the poverty level. States that refused to participate in this expansion would risk losing federal funding for their current Medicaid programs. However, the Supreme Court ruled the federal government could not withdraw existing Medicaid funding to punish states for not expanding their programs, thus giving states the choice to opt out of the expansion. More than a few states have expressed intentions of doing so.
The federal government would pick up the tab for most of the Medicaid expansion when it is implemented in 2014, but states would be required to pay for 10 percent of it by 2020. Though a countrywide expansion would provide coverage for some 17 million Americans who otherwise do not qualify for Medicaid, some states, including Florida, Mississippi, Colorado, and Pennsylvania, say that paying for even 10 percent of the expansion is too much for their tight budgets.
Proponents of the healthcare law say that in the long-term, the Medicaid expansion will save both state and federal governments money while extending healthcare coverage to millions of lower-income Americans. Opponents say it is just another example of government overreach and that it is up to the states to determine whether they can afford such an expansion.
Is Medicaid expansion good for the states? Here is the Debate Club's take.
The Arguments
No — States can't afford the financial burden of expanding Medicaid
RICK SCOTT, Republican Governor of Florida Comment (19)
No — Medicaid expansion would harm the poorest, not help them, as states take the fall
GRACE-MARIE TURNER, President of the Galen Institute Comment (1)
No — State can't afford the expenses of additional Medicaid enrollees
MICHAEL D. TANNER, Author of 'Bad Medicine: A Guide to the Real Costs and Consequences of the New Health Care Law' Comment
Yes — Hospitals will struggle to care for patients without Medicaid expansion
MAGGIE MAHAR, Author of 'Money-Driven Medicine: The Real Reason Health Care Costs So Much' Comment (1)
Yes — Expanding Medicaid allows low-income people to move into the workforce
SCOTT RANDOLPH, Democratic Florida State Representative Comment (4)
Yes — Expanding Medicaid is a moral imperative and fiscal imperative
ETHAN ROME, Executive Director of Health Care for America Now Comment
Yes — States can increase Medicaid without significant revenue increases
RICK MAYES, Associate Professor of Public Policy at the University of Richmond Comment (1)
