Policy Documents

The Leaflet - States Continue to Look Into Medicaid Expansion

March 21, 2014

States Continue to Look Into Medicaid Expansion 

As states continue to consider whether they will expand Medicaid under the Patient Protection and Affordable Care Act (PPACA), some are turning to Arkansas’ “private option” plan as guidance. The plan was promoted as a market-oriented approach, but free-market advocates have pointed out this expansion will cause many of the same problems as traditional Medicaid expansion, including massive and irreversible spending increases.
New Hampshire is one of the latest states to consider Medicaid expansion by adopting a form of the “private option.” The plan currently under consideration would expand Medicaid in two groups. About 12,000 people could receive coverage before July if they qualify for a current program that provides a subsidy for employer-based coverage, and an additional 38,000 would receive federal Medicaid dollars to purchase private insurance. Despite the private-market feel of the plan, it is simply a smokescreen. Like any Medicaid expansion, much of it would be dictated by the federal government, and its implementation would be extremely difficult to roll back.
As Heartland Senior Fellow Benjamin Domenech states, “There is no justifiable case to be made for accepting the Obamacare Medicaid expansion at this juncture as a fiscal conservative. The funds will not end up in another state if you deny them; you will be putting able-bodied adults ahead of the disabled in the line for care; and the federal government will put your state taxpayers on the hook for more tax dollars. There is no such thing as free money, and the strings attached to this ‘free money’ will be a problem for states for decades to come should these expansions go through.” Medicaid expansion will further bloat a flawed and costly program that delivers subpar health care and shifts power to the federal government.

Health Care

New Hampshire legislators are nearing a deal that would expand the state’s Medicaid program, using a model similar to one employed in Arkansas, where federal Medicaid dollars are used to purchase private medical insurance. Currently, New Hampshire’s Medicaid program covers low-income children, parents with non-disabled children under age 18, pregnant women, older residents, and people with disabilities. The proposed expansion would add about 50,000 Medicaid recipients, including anyone under 65 who earns up to 138 percent of federal poverty guidelines. In this Research & Commentary, Senior Policy Analyst Matthew Glans contends that like other plans based on Arkansas’ “private option,” the New Hampshire plan has several shortcomings. Read More
Energy & Environment
Among the most popular justifications for interventionist energy policies is pursuit of a government-imposed “diversified” energy portfolio. Renewable power mandates, net metering laws, and feed-in tariffs are among the most common of such interventionist energy policies states have implemented. Legislators should focus on repealing government policies that intervene in energy markets, such as mandates and subsidies, and instead allow open and competitive marketplaces to work. Read More
Budget & Tax
Maryland Gov. Martin O’Malley in January released a plan to raise the state’s minimum wage from $7.25 an hour to $10.10 an hour by 2016 and index it to inflation in perpetuity. O’Malley’s proposal also would require tipped employees to be paid a cash wage of at least 70 percent of the state’s minimum wage. Maryland’s current minimum wage is equal to the federal minimum wage and competitive with many of its neighboring states—those in New Jersey, New York, and Connecticut are slightly higher. A minimum wage of $10.10 would far surpass those of Maryland’s neighbors. In this Research & Commentary, Senior Policy Analyst Matthew Glans discusses how increasing the minimum wage would have a dramatic negative effect on jobs and Maryland’s economy. Read More
Following the recent financial data breaches at Target and other stores, several legislators and consumer groups have called for new regulations requiring banks and retailers to transition from the current magnetic strip, swipe, credit card system, to a chip-and-PIN system. In this Research & Commentary, Senior Policy Analyst Matthew Glans examines chip-and-PIN cards and argues that a government-mandated switch is not necessary, since the market is already moving in this direction on its own. Instead of imposing a chip-and-PIN mandate, the government should allow the market to come to agreement on how to improve security and develop the technologies to make electronic transactions safer. Read More
Oklahoma legislators are considering an education reform that has garnered significant national attention: the Parent Trigger. The legislation, first passed in California, has been considered in approximately 20 other states. A Parent Trigger typically allows a simple majority of parents at a school to “trigger” one of several reform options, including its conversion to a charter, closure, and offering students vouchers with the school’s per-pupil funds. The Oklahoma bill would give parents the ability to petition the state to replace school staff and leaders at a low-performing public school and to convert it into a charter school.Read More

From Our Free-Market Friends
This convenient pocket-size booklet from the Tax Foundation compares the 50 states on many measures of taxing and spending, including individual and corporate income tax rates, business tax climates, excise taxes, tax burdens, and state spending. It allows you to see how your state compares nationally with other states. Read More

The March issue of School Reform News reports on the challenges private schools, especially religiously affiliated schools, are confronting in the face of subsidized competition from the charter school movement. “No sector of education is perfect, but for the most part faith-based schools have been fairly strong,” says Peter Hanley, executive director of the American Center for School Choice. “Let’s not watch this sector ... die when most agree that one of the problems in American education is that we do not have enough good schools.”

Budget & Tax News

Environment & Climate News