Q: What are some arguments for the Medicaid expansion?
A: The program will provide coverage to millions of low-income people, most of whom are working and paying taxes that support other government health care programs, such as Medicare. Scholarly studies have shown that Medicaid coverage does improve access to medical care and people report they are in better health and not as worried about bills.
Hospitals, which by law must provide emergency care to the uninsured, will get an important new source of money to offset the cost of charity care. The financing will allow hospitals to add jobs, and will also have a positive economic impact on dozens of other businesses in local communities.
Low-income childless adults are the main beneficiaries of the expansion. A few states that cover them already will save money because the federal government will pick up costs those states have been bearing. Low-income parents not currently covered will also benefit.
Q: What are some of the arguments against the Medicaid expansion?
A: A federal government awash in debt can’t be trusted to keep its promises. States that expand coverage will be hard pressed if Washington later tries to scale back its financial commitment. It won’t be easy to simply pull the plug on the expansion because people will be depending on the coverage. States could get hit with a cost shift.
Washington passed up the opportunity to overhaul Medicaid’s convoluted rules and give states more flexibility with the program. Medicaid is a major share of the budget in every state, forcing wrenching decisions between health care and other state priorities such as education and law enforcement. Even if states pay only a fraction of the cost, that is still real money.