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Finding out what’s in it: The 24 states that have accepted the Obamacare Medicaid expansion are about to have their budgets overwhelmed by the much larger numbers of enrollments in that program than was expected.
Obamacare’s Medicaid expansion makes working-age adults with no kids and no disabilities eligible for a welfare program that was costly and ineffective long before Obamacare. The 24 states with a year or more of data available expected no more than 5.5 million would ever sign up, but their expansion enrollment is already 11.5 million – more than double its projected all-time maximum.
Alaska, Indiana, Louisiana, and Montana have not yet released a year of enrollment data, but have all reported Obamacare expansion enrollment higher than their expected maximums, FGA vice president of research Jonathan Ingram and FGA senior research fellow Nicholas Horton noted. “Medicaid expansion already makes welfare for able-bodied adults a higher priority than services for the nearly 600,000 seniors, children with developmental disabilities, individuals with brain injuries, and other vulnerable individuals currently languishing on waiting lists for needed Medicaid services,” Ingram and Horton wrote. “Mounting overruns will soon exacerbate pressure on policymakers to shift even more money away from the truly needy and towards ObamaCare’s able-bodied adults.”
Obamacare expansion benefits are 100 percent federally funded through the end of the calendar year, which has shielded states from billions of dollars in cost overruns since expansion took effect in January 2014. That will soon change. If Obamacare remains in place, states will be on the hook for five percent of their rapidly rising Medicaid expansion costs starting in January. And if President-elect Donald Trump and Republicans in Congress fulfill campaign promises to repeal Obamacare, federal funding for Medicaid expansion could be cut off in a matter of months.
On this issue, at least, there is precedent for congressional Republicans sticking to their word. Last January, President Obama vetoed an Obamacare repeal bill that would have ended Medicaid expansion.
Even if Obamacare is not repealed, these states still face serious budget problems because the cost of this program is, like everything else in Obamacare, far higher than predicted. If Obamacare is repealed, then these states face bankruptcy.