A provision of the Affordable Care Act (Obamacare) sought to extend insurance coverage to the uninsured through an expansion of the Medicaid program, the generally successful program that, for over forty years, has ensured that the poorest of the poor have some access to healthcare. Seemed like a good idea at the time. The Supreme Court, however, ruled that, since Medicaid is administered at the state level, individual states had the right to choose whether or not to allow such Medicaid expansion. Now, as the ACA nears implementation, a number of states are balking at an extension of Medicaid, which means that, ironically, a number of uninsured people will find themselves too poor to receive financial assistance to pay for healthcare.
Now, the fact that the states planning to reject Medicaid expansion are all under Republican leadership should in no way suggest that the rejection is a political ploy to make Obamacare look bad. This is purely about fiscal rectitude! After all, the states reasonably point out that their own budgets are stretched already. How can they afford to take on an unfunded mandate like Medicaid expansion?
Well, OK, it's not completely unfunded: For the first three years, in fact, the federal government will pick up 100% of the new costs. But, still, what about when those three years are up? Then--THEN--the states will find themselves stuck with all the costs for all those people who have become accustomed to not going bankrupt when they need to see a doctor!
Well, OK, they won't be stuck for all the costs, but the federal contribution to the state's coffers will shrink dramatically from 100%--all the way down to 90%!!!
OK, yeah, it's a political ploy to make Obamacare look bad. Why do I even bother to be indignant?