Tennessee, Wyoming Reject Obamacare's Medicaid Expansion (Again)
Medicaid is back in the news as pushes to implement Obamacare's expansion in Tennessee and Wyoming came to a head last week—with both states rejecting the expansion.
First, Tennessee:
Tennessee was widely seen as the next Republican state that could expand Medicaid under Obamacare, with Haslam negotiating with federal officials for months on an approach that included conservative policy elements. But Insure Tennessee always faced significant obstacles in getting legislative approval, and it was killed even though hospitals had agreed to cover the state's share of the costs.
The 7-4 vote against the plan by the state Senate Health and Welfare Committee came after impassioned testimony on both sides of the debate. The plan has little chance of being revived during the regular legislative session.
The "hospitals will cover the cost" proposal is becoming a common sleight of hand in the realm of conservative Obamacare apologetics. Those costs would be passed on to customers, either directly through their bills or indirectly through their taxes. It's not free money.
And then there's Wyoming:
Several senators said Friday they don't trust federal promises to keep paying. Some said they don't want to contribute to the national debt by accepting more federal dollars in any case.
"Make no doubt about it, this saddles more debt upon your children and your grandchildren," said Sen. Larry Hicks, R-Baggs, who voted against the bill.
[Sen. Michael] Von Flatern said that Friday's vote could make it harder to get expansion in the future because the bill to the state will be higher.
Mr. Hicks is exactly right that the expansion is being funded out of debt, and Mr. Von Flatern is similarly right that the direct costs of the expansion are on the way and will make later expansion fights tougher for Obamacare proponents. Right now supporters are relying on the "no money down" provisions of Medicaid expansion; once that's gone, then the question of how a state actually pays for the program comes into sharper focus.
Missouri should continue rejecting bad policy like the expansion. It certainly isn't alone in doing so.
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