“For states, it’s the medium to long-term fiscal picture that presents the biggest worry. The long-term politics of federal budgeting make short-term state policy choices rather dicey: Who knows what Congress will do as the cost of government health programs rise and the already bad budget situation grows worse? Cost shifting to states may not be inevitable, but it’s quite likely, which means that even if expanding Medicaid is essentially free now, it almost certainly won’t be in the future.”
“On Wednesday Florida Republican Rick Scott became the latest GOP Governor to volunteer to shoulder some responsibility for ObamaCare, which has liberal sages gloating about a resistance-is-futile shift in the GOP. The media don’t want to discuss the substance, only the politics, so allow us to report how the flippers are justifying their flips.”
“Gov. Scott Walker announced Wednesday that he won’t propose expanding Medicaid services in Wisconsin, joining other Republican governors who have decided to reject federal money for covering more low-income residents under the health care overhaul law. Instead, Walker outlined a hybrid approach that would allow more adults into the state health program, which he said would help cut the state’s uninsured rate of 14 percent in half.”
“The Obama administration is late in implementing several provisions of the federal health overhaul intended to improve access to care and lower costs. The programs, slated to take effect Jan. 1, were supposed to increase fees to primary care doctors who treat Medicaid patients, give states more federal funding if they eliminate Medicaid co-pays for preventive services and experiment with changes to how doctors and hospitals are paid by Medicare.”
“Months since the Supreme Court ruling that made the Obamacare Medicaid expansion optional, the state costs associated with expansion still remain highly uncertain—making expansion a dicey course for states and their budgets.
Indeed, states should not lose sight of the fact that the original Medicaid expansion was coercive for a reason.”
“The fundamental flaws in our system are familiar: perverse incentives that encourage excess treatment, high prices, poor service (even dangerous sloppiness), incomprehensible complexity and a flawed safety net. But to all such problems the new health-care law has the same two answers: more insurance and Medicaid and more top-down cost control.”
Increase Medicaid payments for primary care services provided by primary care doctors for 2013 and 2014 with 100% federal funding.
“As we have seen, the same bill that insures 32 million new people also will force middle- and upper-middle-income families to have more generous coverage than they now have. As these more generously insured people attempt to acquire more medical services they will almost certainly out-bid people paying Medicaid rates for doctor services and hospital beds. To make matters worse, the health reform bill did nothing to increase the supply side of the market to meet the increased demand.”
“Recent decisions by the Obama Administration concerning the health care exchanges and Medicaid expansion underscore what a risky proposition the Patient Protection and Affordable Care Act (PPACA) is for the states. Congress presumed in PPACA (Obamacare) that the states would agree to build and run exchanges and could be forced to expand Medicaid. The Supreme Court, however, ruled the Medicaid expansion voluntary, which has made states increasingly concerned over new burdens related to costs, control, and coverage—in both the exchanges and Medicaid.”
“States already struggling to get by will face even tighter fiscal constraints thanks to yet another costly Obamacare mandate. A study last week from the Kaiser Commission on Medicaid and the Uninsured revealed President Obama’s health care takeover would dump $1 trillion in new costs on federal and state taxpayers over the next decade.”