GOP's Medicaid Expansion Plans Encounter Growing Skepticism

While states debate expanding their Medicaid programs under Obamacare, they're wrestling with a looming 2017 deadline — when their taxpayers begin paying for the cost of the expansion.

Beginning in 2014, states that agree to expand Medicaid to persons with incomes of up to 138 percent of the poverty line will have the federal government pay 100 percent of the cost. But beginning in 2017, the federal share will fall to 95 percent, and it drops to 90 percent in 2020.

This has officials — many of them in Republican-dominated states across the country — worried that they will not be able to avoid the spiraling costs.

"It's not like we have $78 million sitting on the shelf," Utah state Rep. Jim Dunnigan, a Republican skeptic of Medicaid expansion, told The Washington Times.

In Utah, Republican Gov. Gary Herbert is touting Medicaid expansion as a way to expand health insurance to 58,000 additional people in his state. But Herbert and other GOP governors looking to expand the program are laboring to find ways to offset the additional costs their taxpayers would have to pay.

Some of the governors talk of imposing cigarette taxes or fees on hospitals that stand to gain from Medicaid expansion.

Indiana Gov. Mike Pence proposed his own Medicaid expansion plan in May, saying it would be financed through a fee on hospitals and revenue from cigarette taxes.

In Tennessee, Republican Gov. Bill Haslam is pushing his own two-year pilot plan, Insure Tennessee.

Haslam, elected chairman of the Republican Governors Association last month, said that the program would not be a financial burden because hospitals have promised to pay any additional costs, and that it would be ended if the federal government or the hospitals failed to keep their commitments.

His arguments in favor of Insure Tennessee drew heavy fire from The Washington Times, which cited statistics from the Urban Institute showing that almost 90 percent of Tennessee's Medicaid expansion population consists of able-bodied, working-age adults without children.

"When nine out of 10 of these new Medicaid welfare recipients are healthy adults who should be expected to take care of themselves without a government crutch, no amount of conservative window dressing can hide the truth," the paper editorialized.

"Mr. Haslam's foolish flip-floppery is doubly unwise because Tennessee has been burned by Medicaid expansion before," the paper said. "When the state's most recent Republican governor expanded Medicaid eligibility 15 years ago, it nearly bankrupted the state. The actual needy, struggling by on Medicaid, had fewer and fewer services."

One of the sharpest critics of Medicaid expansion is Louisiana Gov. Bobby Jindal, who last month criticized President Barack Obama for "doubling down on a failed approach" by expanding entitlements when the federal government cannot afford the ones already in place.

Related Stories:

• Bobby Jindal: Medicaid Expansion Robs People of Private Insurance
  
• Health Systems Can't Handle Influx of Obamacare Medicaid Recipients