Policy Documents

Why States Should Not Expand Medicaid

Grace-Marie Turner and Avik Roy –
May 1, 2013

States are being strongly pressured to expand Medicaid to families earning up to $30,000 a year, as the Affordable Care Act allows.

While several high-profile governors have agreed to expand this broken program, many others governors and state legislators are cautious.  They are correct to be concerned.

They don’t want to deny people access to health care. But they do want to halt expansion of a program that provides limited access to quality care while devouring state budgets. Many political leaders are demanding that Washington allow states to improve Medicaid for their most vulnerable citizens.

Medicaid — the joint federal and state program designed to finance health care for the poor — has not been fundamentally changed since it was created in 1965.  Legislators know Medicaid desperately needs to be modernized for the 21st century, and even President Obama argued the case during the debate over ObamaCare.  “It is not sufficient for us simply to add more people to Medicare or Medicaid to increase the rolls, to increase coverage in the absence of cost controls and reform,” Mr. Obama said, adding that “another way of putting it is we can’t simply put more people into a broken system that doesn’t work.”