The Medicaid expansion under the Affordable Care Act would cost Pennsylvania an additional $2 billion through 2019, should the commonwealth participate. That represents merely the state share, as taxes to the federal government will pay the lion’s share of the expansion.
But even without the expansion, Medicaid costs were soaring at an unsustainable rate. And adding more individuals into the Medicaid program, which provides poor access to doctors, treats the symptoms of no insurance but fails to treat the cause-the high cost of health care.
Such crippling costs are causing other states to decline expanding Medicaid under the Affordable Care Act, a provision made voluntary by the Supreme Court ruling last month. Florida Gov. Rick Scott summed up the growing opposition to the expansion: “Florida will opt out of spending approximately $1.9 billion more taxpayer dollars required to implement a massive entitlement expansion of the Medicaid program.”
South Carolina, Texas, Louisiana and Florida have firmly stated they will do nothing to implement the Affordable Care Act—meaning they will not expand Medicaid or create a state health insurance exchange. Altogether, five Governors have committed to not expanding Medicaid and five more states are leaning towards rejection.
Instead of new federal mandates, states need greater flexibility to reform their medical assistance programs. This could occur through a Medicaid waiver or through legislation to block grant Medicaid to the states.