The Supreme Court upheld Obamacare’s individual mandate to purchase health insurance, but it also struck down part of the law. That part—forcing states to expand their Medicaid programs—offers governors some much-needed relief.
Expanding Medicaid, the government health insurance program for the poor and disabled, was one of President Obama’s main ways to increase the number of insured people through Obamacare. This was no magic solution for the uninsured, especially since Medicaid is in need of reform, not expansion.
States’ share of the cost of Medicaid is already crushing state budgets. “In the past decade, Medicaid spending has increased at nearly twice the rate of states’ tax revenue,” according to a new report.
The only ways to expand Medicaid are to raise taxes, cut other state programs, or slash health care providers’ reimbursements in Medicaid even more. And so far, the majority of America’s governors have not committed to making the expansion.*
Governor Bob McDonnell (R–VA) sent a letter to President Obama on behalf of the Republican Governors Association: “Before making any final policy decisions,” he explained, “governors must carefully consider the short and long-term implications of an expanded entitlement program and the consequences of significantly increasing the size of government to manage these programs.” The question of a Medicaid expansion faces every state, including Democratic governors who are still on the fence.