Last week the White House released a report titled, "Missed Opportunities: The Consequences of State Decisions Not to Expand Medicaid." As you might expect with a political document, the White House's paper was released to coincide with contemporary political events—specifically, a legislative debate over Medicaid expansion in Florida, whose circumstances I've discussed on this blog before. Florida's House ultimately rejected the expansion proposal. That was the right decision.

Unfortunately, there isn't much new in the report. As expected, the authors conflate Medicaid "coverage" and medical care, when the concepts are very different things, and they gloss over the fact that throwing more beneficiaries into the Medicaid program will actually make care delivery to the most vulnerable even more difficult.

Show-Me Daily readers may not be surprised, then, that my reaction, printed in the St. Louis Post-Dispatch, was not exactly high on the report's contents.

But opponents say such studies and data miss the mark when evaluating whether states should expand Medicaid eligibility. Patrick Ishmael, a researcher at the conservative Show-Me Institute, said the current program is "deeply broken" and that adding more people to it would be irresponsible and immoral.

Medicaid beneficiaries and Missouri taxpayers deserve a better program, not these tired talking points, and there are many reforms out there that deserve to be debated.

But that debate is not helped along by reports like this from the White House. Expansion is not reform; coverage is not care. Until the White House and Obamacare supporters in general take those facts to heart, fixing Medicaid in any sort of meaningful way will continue to be very, very difficult in the near term.