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Obamacare and the Medicaid Expansion: How Does Your State Fare?


Obamacare and the Medicaid Expansion: How Does Your State Fare?

New Jersey is a Net Payer

Drew Gonshorowski
March 5, 2013 at 1:28 pm

The Medicaid expansion is touted by proponents of Obamacare as a “no-brainer.” While it is true that some states may see projected savings, it is erroneous to claim that this experience applies to every state.

Proponents predict that by expanding Medicaid states will be able to reduce payments to health care providers, such as hospitals, for uncompensated care. As a matter of fact, nationally, the opposite is true:

40 of 50 states are projected to see increases in costs due to the Medicaid expansion.
The majority of states see costs exceed savings when the federal match rate is lowered after the first three years. From there, state costs continue to climb, dwarfing any projected savings.

State savings are concentrated in large states. New York is estimated to see $33 billion in savings, while Massachusetts is estimated to save $6 billion over 10 years. Because of the design of their current programs, these states have a unique opportunity to restructure their programs and transfer significant cost to the federal ledger. (continues below chart)

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