Non-expansion States Should Follow Kansas’ Lead

Last week, two states rejected measures to expand Medicaid under Obamacare. The Missouri House voted down a Medicaid expansion. In Kansas, Governor Sam Brownback vetoed legislation passed by the state legislature. The legislature then attempted but failed to override Brownback’s veto.

Medicaid originally existed as a safety net to provide care to children, disabled persons, and pregnant women, but thanks in part to Obamacare, the program has strayed far from its original intent now granting eligibility to low-income able-bodied adults. Initially, the federal government absorbed the entire cost of state’s expansion leading to a flood in enrollment far outpacing initial estimates. However, the federal government’s matching rate will continue to decrease down to 90% by 2020 and shift costs back to already strained state budgets.

As enrollment skyrockets, inevitably Medicaid shifts resources from those whom the program was originally designed to protect to its new beneficiaries that could be in the private market. Enrolling millions of new patients, even as many doctors refuse to take Medicaid patients, adds to the program’s pre-existing structural problems. Handing out useless insurance cards does not ensure positive health care outcomes.

The federal government will not pick up the tab forever, and once that happens, states will be forced to address their dependence on the federal government. Politicians continue to tout expansion as the “right thing” to do, but in reality it is easy for politicians to accept free money now and let someone else worry about the consequences later.

Real compassion necessitates policy solutions that help make health care affordable, strengthen the patient-doctor relationship, and expand access to quality care. Handing out more insurance cards may look politically popular, but states must resist the temptation to expand an unaffordable program that fails to meet patient’s needs.

The eighteen states who have not expanded Medicaid ought to follow Missouri and Kansas’ lead and continue to reject the unsustainable expansion.


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