Virginia should think twice about joining the Medicaid expansion mess

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Across the country, states like Ohio and Kentucky are trying to reel in their failed ObamaCare Medicaid expansions. But as those states are moving forward with enrollment freezes and work requirements to roll back expansion, Virginia’s governor and House leadership are moving backwards by trying to implement ObamaCare.

Less than six months ago, the same Virginia House leadership decried Medicaid expansion, saying “free and guaranteed money from D.C. isn’t always free and guaranteed.” The facts on the ground have not changed. So why have they?

{mosads}If anything, the facts look even worse for expansion states, given that President Trump’s budget repeals and defunds ObamaCare expansion. It’s a sentiment reiterated by Mick Mulvaney, Director of the Office of Management and Budget, when he tweeted his opposition to Medicaid expansion in Virginia. This is an issue in a state like Virginia, where Medicaid continues to account for the largest amount of state spending growth—especially given that federal and state spending on Medicaid has increased 74 percent in the last decade. It’s not a matter of if federal funding goes away for Medicaid expansion, but when.


Nationwide, ObamaCare expansion has been a failure, flooding Medicaid rolls with 12.7 able-bodied adults—adults with no disabilities keeping them from working—and prioritizing this new class of able-bodied welfare recipients over the truly needy. State and national enrollment estimates have been dangerously inaccurate, as expansion states have enrolled more than double the number of able-bodied adults than ever expected. This isn’t a case of just one plan going wrong—every single state with available data that expanded Medicaid under ObamaCare has enrolled more able-bodied adults than expected, with some signing up as many as four times as many as they had intended.

For Virginia, that means 506,000 able-bodied adults could enroll—179,000 more than state officials have predicted. Given the national trends, it’s hard to ignore the data of what will truly happen.

And this enrollment explosion will have a cost. Despite Medicaid expansion supporters claiming that expansion will increase funding and help the state budget, the opposite is true. Nationwide, ObamaCare per-person costs have exceeded estimates by 76 percent—leading to massive cost overruns of 157 percent. That’s less money for critical priorities like education, public safety, and infrastructure—things the Commonwealth should be prioritizing. And because the same dollar can’t be spent twice, that’s less resources for the truly needy, including the elderly, children, and people with disabilities, among others.

And it’s more money out of taxpayers’ pockets. Just ask our neighbors in West Virginia, where Medicaid enrollment exceeded the projected maximum in just three months and has cost taxpayers more than half a billion dollars more than promised.

Or consider our other neighbor Kentucky, where expansion has cost taxpayers nearly $6 billion — nearly twice what was promised.

Right here in Virginia, new estimates of the projected cost of expansion are over $28 billion — more than $10 billion over initial projections.

This is real money, and it’s got to come from somewhere.

Virginia has avoided this crisis, so why are House leaders now so eager to jump headfirst into a fiscal nightmare? Some claim that expansion will help the truly needy. Surprise — it won’t. In fact, we know from experience nationwide that Medicaid expansion will make life harder for the truly needy Virginians who depend on it today. The perverse funding structure of expansion actually prioritizes able-bodied adults over the truly needy, threatening resources and care for those who need it the most.

Nationwide, more than 650,000 truly needy individuals are currently languishing on Medicaid waiting lists, waiting for care and services they desperately need. Why would we choose to spend resources on able-bodied adults instead of on those who truly need our help?

The facts speak for themselves when it comes to ObamaCare expansion — and they don’t look good.

Christie Herrera is the vice president of state affairs and policy fellow at the Foundation for Government Accountability, a nonprofit group dedicated to limiting the scope of government.

Tags Christie Herrera Donald Trump Medicaid Mick Mulvaney Virginia

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