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States Rejecting Medicaid Expansion Forgo Billions in Federal Funds

John Commins, for HealthLeaders Media, December 5, 2013

The 20 states rejecting Medicaid expansion are leaving billions of dollars in federal funds on the table, even as the taxpayers of those states pay for the expansion costs for states that accept the deal.

The 20 states that are rejecting Medicaid expansion under the Patient Protection and Affordable Care Act are leaving billions of dollars in federal funds on the table, even as the taxpayers of those states pay for the expansion costs for states that accept the deal, a new study from the Commonwealth Fund shows.

"In states that don't expand their Medicaid programs the people in their state who are below 100% of poverty will not be eligible for new options for health insurance under the ACA," says Sara Collins, vice president, healthcare, at the Commonwealth Fund. "Taxpayers across the country are contributing to this program, but for the states that don't expand their programs it means that they are not getting those benefits that the residents in other states are getting. There is both a healthcare loss for individuals who aren't eligible for any of the new options under the law and there is a significant economic loss for states that don't move forward."

The study—How States Stand to Gain or Lose Federal Funds by Opting In or Out of the Medicaid Expansion—examines federal taxes paid by state residents. States with the highest net losses include Texas, which will see a net loss of $9.2 billion in 2022; Florida, which will lose $5 billion; Georgia, which will lose $2.9 billion, and Virginia, which will lose $2.8 billion.

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2 comments on "States Rejecting Medicaid Expansion Forgo Billions in Federal Funds"


Todd (12/15/2013 at 11:40 AM)
"In addition to improving access to care and financial security for the newly insured..." Exactly how does this expansion guarantee access? Providers have to take on all those additiona patients at low reimbursements.

Robert Trinka (12/5/2013 at 5:02 PM)
Irrespective of the short run benefits to a state of expanding Medicaid and accepting Federal funds, the fact is that expanding the Medicaid program will create massive liabilities for states that are participating. The long run unfunded liabilities of this program will be in the trillions of dollars over the next 10+ years. As a state taxpayer, I fully support my state's decision not to take on these liabilities for a short-term fix. And consider whether the Federal Government will be able to meet its obligations under the program and make the payments to the states as promised - that is not guaranteed. There are other, less expensive and less risky ways to provide healthcare to a state's population.