Medicaid expansion rejection bites back

The expansion of Medicaid health benefits to people who were too poor to be eligible for the health insurance subsidies was supposed to be an integral part of the Affordable Care Act. But the US Supreme Court ruled that it was an option that states could choose to accept or reject. And of course two-dozen Republican-dominated states chose to reject it even though it seemed like a no-brainer since the federal government would pick up 100% of the costs in the first three years and about 95% after that, because god-forbid that poor people should get health insurance.

Well, it turns out that those states are now hurting because poor people still live in those states and they still need health care but the money to treat them properly is not there, resulting in the ratings agencies downgrading health care entities in those states.

Reports out in the last week indicate the gap between those with health care coverage is widening between states that agreed to go along with the health law’s Medicaid expansion and those generally led by Republican legislatures and GOP governors that are balking at the expansion.

The moves against expansion are “beginning to hurt hospitals in states that opted out,” a report last week from Fitch Ratings said. The U.S. Department of Health and Human services has said Medicaid enrollment in the 26 states and the District of Columbia that agreed to go along with and implemented the expansion by the end of May “rose by 17 percent, while states that have not expanded reported only a 3 percent increase,” HHS said in an enrollment update for the Medicaid program.

“We expect providers in states that have chosen not to participate in expanded Medicaid eligibility to face increasing financial challenges in 2014 and beyond,” Fitch said in its July 16 report. “Nonprofit hospitals and healthcare systems in states that have expanded their Medicaid coverage under the Patient Protection and Affordable Care Act have begun to realize the benefit from increased insurance coverage.”

But as long as the moochers and looters are deprived of benefits, health or otherwise, the Republican party is happy.


  1. says

    “But as long as the moochers and looters are deprived of benefits, health or otherwise, the Republican party is happy.”

    The repugnanticans are the moochers and looters!

  2. Pierce R. Butler says

    Actually, the original Medicid program was abolished by Ferdinand & Isabella in 1492 after completing the first phase of their ethnic cleansing project, when anti-Moorish he-man crusaders’ heath care was no longer deemed necessary.

  3. Mano Singham says


    Aargh! I can’t believe that I made another mistake on the same word!

  4. northstar says

    I think it’s less that the “moochers and looters” will get health care, than the problem of um, low-information Republican voters getting health care and perhaps reconsidering their affiliation. This could be a huge problem for the Republican party — it’s their base. They spent a lot of time pushing the meme that passing Obama care would make things worse for people and worked hard to make it seem true. It worked, to some extent; I see discussions about how Obamacare is ruining people’s lives and invariably it turns out they are in a state that refused to expand the coverage.

    On the other hand, I see in my state, which did expand the coverage, the Republican’s worst fears coming true. In my own heavily Republican, low-information voting, low-income extended family, they still hate Obama but there isn’t a peep anymore about Obamacare, because they are probably getting health care for the first time in their adult lives. It’s an astonishing silence, moreso in contrast to the rage and rhetoric they previously voiced against the ACA.

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