Observing that "the war on the poor is good politics these days in about half of America," Jeff Madrick considers the current and future state of Medicaid expansion:
[Medicaid] is administered by state governments, which are allowed to set their own eligibility requirements and other standards. In many states, this has meant that a working family only qualifies if it earns no more than 63 percent of the poverty line—about $14,000 a year for a family of four. An individual who is not a parent does not qualify for Medicaid at all, no matter how low his or her income…. In contrast, the ACA expands coverage to all individuals, whether parents or not, who earned up to 138 percent of the poverty line—nearly $30,000 for a family of four.
He adds that the claim that Medicaid expansion would cost states is largely unfounded, pointing to the new CBO report (pdf):
[Some governors] say their state budgets can’t afford the small portion of costs, at most several percent, that they will have to pay. Governor Rick Scott of Florida, for example, has made the wild claim that it would cost Florida some $1.9 billion to comply with the expansion. But the hard numbers simply do not support these arguments. The new CBO report estimates the federal government will cover 93 percent of all costs over ten years, and 90 percent after that. Moreover, because more of the poor will be covered, the costly emergency medical care they often receive at the last minute in ER rooms will be reduced, saving states money.
Sarah Kliff shows how the resistance from governors is hardly partisan:
Phil Galewitz and Matthew Fleming surveyed all 50 states to find out how Medicaid budgets are changing. They found that 13 states had made cuts this year…. It’s hard to find any common thread among these 13 states. Seven have Democratic governors; six are led by Republicans. Three are in the south and an equal number are in New England. Two, California and Connecticut, seem to really like the Medicaid program: They volunteered to start the health law’s Medicaid expansion early, well before it’s required in 2014. Others, like Louisiana and Florida, are not fans at all: They plan to sit out that Obamacare provision. All told, it’s pretty hard to find any narrative that explains why these states have cut their Medicaid programs, aside from some broad truths: Budgets are still squeezed and Medicaid is eating up a growing chunk of state spending.
Meanwhile, Charles Blahous explains that the CBO report shows that the federal financial burden is actually increasing:
CBO anticipates that as a result of the Supreme Court ruling, some people won’t be covered under Medicaid and will go to the exchanges instead (increasing federal costs), whereas others won’t be covered at all (reducing federal costs by even more). So while per-capita costs go up, CBO projects that the aggregate cost of the coverage expansion in isolation is now lower than before. Yet, despite this anticipated source of fiscal improvement, the law’s overall fiscal effects are still worse than previously projected.
The Dish 