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Old 11-02-2013, 07:37 PM   #23
CrazyPhuD CrazyPhuD is offline
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Well first major issue, the states that didn't expand medicaid didn't cause people to lose their medicaid coverage. They never had it in the first place, this program was an expansion to add more people to medicaid.

Frankly the rationale behind this is fairly straight forward if you think about what the expect the long term costs to be. While the short term costs don't look bad, they are realistically a suckers bet. First three years looks great in that the Feds pay 100% and then 90% after. The problem is that no one should expect the 90% payment levels to be maintained. Afterall why should one group of medicaid patients be subsided more than another. Considering that current medicaid patients are subsidized 50-75% by the feds it's likely that the long term state costs for the expansion will also be 25-50% not the 10% claimed. After all it's not like the current administration is particularly known for keeping promises(realistically no politician is).

This fiscal burden is compounded by the fact that most if not all states can't run a deficit, they MUST pay for everything that year, which means with significant additional costs they have to either raise taxes or cut other services. All for a program that you don't support. Would you do it?

Then there's the final issue, frankly the expansion of medicaid is the roadmap to a single payer system. Why? It starts with a modest expansion today, but what happens when obamacare made insurance so expensive that middle class families that could have afforded their own insurance before now can't? Why not expand medicaid just a little further to cover that group(and then just a little further for the next group and so forth).

While there's no guarantee that they would use medicaid to support a single payer system, one can see the roadmap where they could. Again when you don't support the program and it adds cost to your budget why would you do it? They are the ones who will lose their jobs over raising taxes or reducing services all to fund a program that is far less popular in their states.
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