States that have resisted expanding their Medicaid programs have witnessed the soaring costs in other states and the adverse impact on vulnerable patients already on the program who must compete for providers with expansion enrollees.
As legislators prepare for their upcoming sessions, the Galen Institute and the Foundation for Government Accountability (FGA) have partnered in offering guidance for states based upon experience and research documenting problems with expansion.
Sam Adolphsen of FGA and Brian Blase and Grace-Marie of Galen worked together in preparing “Why states should not expand Medicaid,” a new version of a paper we originally published soon after the Supreme Court decision gave states the option. Our warnings then have proven predictive today.
Although the allure of federal money has led too many states to adopt expansion, doing so will worsen the safety net program for the truly needy, lead many people to replace private coverage with public coverage, will significantly increase state expenditures, will crowd out other vital priorities, and will worsen federal budget deficits, the paper explains.
States should continue to press Washington for greater flexibility to best manage their programs and resist the ACA’s failed Medicaid expansion.
We offer and explain 12 reasons states should resist Medicaid expansion and instead develop alternative programs tailored to their states: