Republican presidential nominee Donald Trump said that as president he would use Medicaid to cover poor people who can’t afford private health insurance, and make birth control available without a prescription.

The comments appeared to differ both with what some Republicans have proposed in the past, and — in the case of Medicaid — aspects of Trump’s own policy proposals on his website. Republicans generally opposed the expansion of Medicaid to higher income levels under Obamacare, for example.

Speaking on “The Dr. Oz Show,” Trump said Medicaid, the joint federal-state program for the poor, should be used to help provide health coverage for those who can’t afford to buy plans from private health insurers. The show was taped Wednesday and aired Thursday.

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One of the more controversial parts of the Affordable Care Act is its expansion of Medicaid. A new study from the Mercatus Center at George Mason University reviews Medicaid’s longstand­ing problems, discusses the incentives states face as a result of the elevated federal reim­bursement rate for the ACA Medicaid expansion population, and analyzes the impact of the expansion. Overall, the expansion significantly adds to Medicaid’s unsustainable spending trajectory, likely fails to produce outcomes worth the corresponding cost, and creates a large federal government bias toward nondisabled, working-age adults at the expense of traditional Medicaid enrollees.

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This week, the Georgia Chamber of Commerce released a new plan to impose more of Obamacare on their state. The Chamber acknowledged that their “guiding principle” in crafting the Medicaid expansion plan was simply to “take advantage of all federal dollars available.” As such, they’re lobbying for policymakers to expand Medicaid to a new welfare class of more than 700,000 able-bodied adults.

Although the “plan” has few details – so far it consists solely of two PowerPoint slides – one thing is certain: it will be a more costly way to expand Obamacare that combines some of the most expensive aspects of other expansion plans from around the country.

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The Obama administration is moving to end duplicate coverage for tens of thousands of people who are enrolled in Medicaid and simultaneously receiving federal subsidies to help pay for private health insurance under the Affordable Care Act.

In the last few days, consumers around the country have received letters warning, in big black type: “People in your household may lose financial help for their marketplace coverage.”

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Canceled health insurance plans, shrinking networks, surging premiums and failed co-ops resulting from President Obama’s 2010 health law are only hiccups compared to Obamacare’s Medicaid expansion.

Unlike other major parts of the law, Medicaid expansion is covering more people than intended. This is terrible news for taxpayers, and it will only get worse with the next economic downturn.

Most of Obamacare’s health insurance coverage gains result from expanding Medicaid–a welfare program previously reserved for the elderly, the disabled, pregnant women and impoverished families with children–to millions of working-age, able-bodied, childless adults. Medicaid expansion is paid for with billions in new federal deficit spending.

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Washington experts have been frequently wrong about the Affordable Care Act.

They projected far more enrollees in ACA exchanges than materialized. They also projected that the individual insurance market would stabilize in 2016 with robust competition. Instead, the country is grappling with enormous premium hikes and fewer choices.

A new government report reveals perhaps the largest mistake yet: Medicaid enrollees who gained coverage through the ACA cost almost 50 percent more, on average, than the government projected just one year ago.

ACA supporters often point to Medicaid expansion as the law’s greatest success since it reduced the overall uninsurance rate. We now know that result comes with a gigantic price tag.

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A government report finds that the cost of expanding Medicaid to millions more low-income people is increasing faster than expected, raising questions about a vital part of President Barack Obama’s health care law.

The law provided for the federal government to pay the entire cost of the Medicaid expansion from 2014 through the end of this year.

Obama has proposed an extra incentive for states that have not yet expanded Medicaid: three years of full federal financing no matter when they start. But the new cost estimates could complicate things.

In a recent report to Congress, the Centers for Medicare and Medicaid Services said the cost of expansion was $6,366 per person for 2015, about 49 percent higher than previously estimated.

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Americans should be more worried than ever about Medicaid, which provides health insurance for America’s most vulnerable. The cost of the $500 billion program is expected to rise to $890 billion by 2024, according to the Centers for Medicare and Medicaid Services. Yet more spending doesn’t necessarily mean better care for beneficiaries, 57% of whom are low-income minorities. The expansion of Medicaid is one of the most misguided parts of ObamaCare—shamefully expanding second-class health care for the poor.

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With Donald Trump’s presidential campaign faltering, Republican health policy experts are gaming out Plan B for working with a Hillary Clinton administration to achieve conservative healthcare goals.

Their focus is on a possible “grand bargain” that would give conservative states greater flexibility to design market-based approaches to make coverage more affordable and reduce spending in exchange for covering low-income workers in non-Medicaid expansion states. A key element, conservative experts say, would be for a Clinton administration to make it easier for states to obtain Section 1332 waivers under the Affordable Care Act. Those waivers allow states to replace the law’s insurance exchange structure with their own innovative models.

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The implementation of major legislation such as the Affordable Care Act (ACA) often results in fiscal outcomes that differ significantly from prior projections. Whenever this happens it leads to many questions, much confusion, and several claims and counter-claims. Rarely is it immediately clear whether the law is working differently than envisioned, or whether the unexpected outcomes are due to inevitable projection errors having nothing to do with the law.

On rare occasion, however, a prior projection proves so far off that its significance must be noted. Two weeks ago my colleague Brian Blase uncovered such a development with respect to the ACA’s Medicaid expansion. Recall that the ACA considerably expanded Medicaid eligibility – an expansion made optional for the states in a later Supreme Court ruling. It turns out that the 2015 per-capita cost of this Medicaid expansion is a whopping 49% higher than projections made just one year before.

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