“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.”

“While other Republican governors are starting to back away from their opposition to implementing a key part of President Obama’s health care law, Louisiana Gov. Bobby Jindal said Tuesday that he’s not reconsidering.”

“To recruit more doctors to treat the poor, President Barack Obama’s health law took a simple approach: temporarily pay doctors more money… But implementing the raise is not so simple… With two months to go, doctors, state officials, and Medicaid managed care plans say there are numerous details still to be worked out.”

“We are about to spend $1.8 trillion over the next ten years insuring about 32 million people. About half of the newly insured will go into Medicaid and half will get private insurance. If the above chart is to be believed, which half you’re in makes a real difference. That tiny little sliver of difference between the green line and the red line is the differential survival between those who are uninsured and those who are in Medicaid. Even after five years, the differential survival is a little more than 1%.”

“Leaders of the deeply conservative state say that even if Mississippi receives boatloads of cash under President Barack Obama’s health care law, it can’t afford the corresponding share of state money it will have to put up to add hundreds of thousands of people to the government health insurance program for the poor.”