“The current Medicaid program is arguably the worst health insurance plan in the country. It has expanded massively beyond the original intent in 1965 and is now one of the two or three largest budget items for nearly every state. In spite
of massive annual increases in spending, Medicaid chronically experiences budgetbreaking costs. Expanding Medicaid, as the new health care reform law requires,
will only compound these problems.”

“Under the 136-page rule, the federal government will now decide what counts as an ‘unreasonable’ rate increase, and HHS Secretary Kathleen Sebelius wrote to Governors yesterday urging them ‘to prevent unjustified and excessive health insurance premium growth.’ Apparently, ‘unreasonable’ means rate increases that exceed 10% next year, except when it doesn’t. If an insurer crosses this arbitrary threshold, ‘The review process would then determine if the increase is, in fact, unreasonable.’ So that’s cleared up.”

“Already, Medicaid is the second largest item on the average state budget at 21% (education is first at 22%). But according to the Centers for Medicare and Medicaid Services (CMS) that is all about to change very soon thanks to Obamacare. Remember, more than half of the health care coverage expansion under Obamacare is attained by placing Americans on Medicaid. CMS projects that state and local spending on Medicaid will increase 41.4% between 2010 and 2011. 41%!!!”

“The federal government is demanding that states spend precious time in upcoming legislative sessions to set up massive new bureaucracies in anticipation of spending billions of dollars to implement ObamaCare… But there are ways states can protect themselves from being swamped by these federal demands.”

“First, ObamaCare’s state-side implementation is going to be very difficult and very complex. Even big, liberal states like California are going to have trouble keeping up with the law’s requirements. Second, that complexity is going to set up a system that’s 1) going to create a lot more interdependence between the government and the private sector and 2) begging to be gamed. That’s presumably why private firms, especially in the consulting sector, are already investing heavily in staff who can explain what the government’s doing and, presumably, how to take advantage of it. “

“The healthcare reform law flunks the test of real healthcare reform. Real reform would: encourage providers to offer higher-quality care at lower costs; reduce the cost pressures that threaten to bankrupt Medicare and Medicaid; and give every American access to more options for quality insurance. To enact real healthcare reform, and help to restore fiscal balance to the nation’s budget, the next Congress should pursue substantial changes to the Patient Protection and Affordable Care Act (PPACA). We recommend the following five healthcare objectives for the 112th Congress.”

“Mr. Obama declared at the time that ‘uninsured Americans who’ve been locked out of the insurance market because of a pre-existing condition will now be able to enroll in a new national insurance pool where they’ll finally be able to purchase quality, affordable health care—some for the very first time in their lives.’ So far that statement accurately describes a single person in North Dakota. Literally, one person has signed up out of 647,000 state residents. Four people have enrolled in West Virginia. Things are better in Minnesota, where Mr. Obama has rescued 15 out of 5.2 million, and also in Indiana—63 people there. HHS did best among the 24.7 million Texans. Thanks to ObamaCare, 393 of them are now insured.”

“The Patient Protection and Affordable Care Act (PPACA) will place unprecedented fiscal pressure on states, several of which are already suffering from multibillion-dollar budget deficits. Although many of the law’s most costly requirements will not take effect until 2014, some states are bracing for billions in new spending, while others have already started to take costly steps toward implementing the new law.”

The state of Texas is considering ending their Medicaid program entirely rather than dealing with new Medicaid costs from ObamaCare. The law’s “maintenance of effort” provisions prevent Texas from modifying eligibility requirements or implementing most other cost-saving measures. This could require new federal spending to offset the reduction.

Since the subsidies for the uninsured don’t begin until 2014, ObamaCare creates high-risk pools to help the uninsured get coverage. This program is so poorly designed and ill-conceived that instead of insuring hundreds of thousands of people, as expected, only about 8,000 people have coverage in the program.