Republicans ready to kill Medicaid expansion

I hadn’t realized that more Americans are enrolled in Medicaid, the health-insurance program for low-income Americans, than in Social Security, Medicare or any other federal benefits program.

And the increase in the number of Americans with health insurance under Obamacare—the Affordable Care Act—is due more to the expansion of Medicaid than to signups of people under the health insurance exchanges.

But Senate and House Republicans have reportedly agreed on a plan to dial back the Medicaid expansion.

Kevin Drum of Mother Jones reported that there are 68 million Medicaid enrollees, making it a bigger program than Social Security (61 million), Medicare (55 million), food stamps (44 million), unemployment insurance (6 million at the height of the recession), the earned income tax credit (26 million) and temporary aid to needy families (about 4 million).

Medicaid was created to provide health insurance for Americans earning poverty-level wages.   Under Obamacare, eligibility was increased to Americans earning 138 percent of a poverty wage.  This would be $16,394 for an adult, according to CNBC News.

The program is administered by state governments.   President Obama’s plan pays states nearly all the costs added by the expanded plan, and then a progressively lesser amount sliding down to 90 percent.  The Supreme Court ruled that state governments cannot be compelled to accept the expanded plan, and 19 state governments, all with Republican governors, opted out.

CNBC reporter Dan Mangan reported that Medicaid has added 15 million enrollees since Obamacare went into effect, a figure which includes some people who would have been eligible under the old rules.   That’s nearly 4 million more than signed up for health insurance under the Obamacare exchanges.

The American Health Care Act as enacted by Republicans in the House of Representatives would phase out Medicaid expansion over three years.   Sarah Kliff of Vox news reported that Senate Republicans have agreed to a compromise plan that would phase out expansion over seven years.

Both plans would take away health insurance from 14 million people, but the Senate plan would postpone the full effect until after the 2018, 2020 and 2024 elections.

Why would Republicans want to end a popular program?   Putting aside the question of the influence of the for-profit health insurance industry, I think it is because they morally disapprove of government burdening the healthy and wealthy to benefit the sick and poor.

Also, Medicaid is contrary to the GOP model for state government, which is to foster economic growth through low taxes, right-to-work laws and benefits to corporations, even if it means less government services and benefits.

The GOP model hasn’t worked.   It confuses the cost of government with overall cost to the public.   If government can provide a service to the public at less cost than a profit-seeking corporations, then the overall cost is less.


Medicare Is the Most Widely Used Benefit Program In Existence by Kevin Drum for Mother Jones.

Obamacare’s Medicaid expansion leading to insurance boom in some states by Dan Mangan for CNBC News.

Obamacare is in real danger by Sarah Kliff for Vox news.

Republicans are closer to killing ObamaCare than you think by Ryan Cooper for The Week.

Senate GOP won’t release draft health care bill by J. Scott Applewhite of the Associated Press.

Medicare Enrollees Compared With Privately-Insured and Uninsured Adults by The Commonwealth Fund (2016 survey)

Policy Basics: Introduction to Medicaid by the Center on Budget and Policy Priorities  [Added Later]

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2 Responses to “Republicans ready to kill Medicaid expansion”

  1. Vincent Says:

    From this side of the Atlantic, US arrangements (or lack of) to provide medical care for all are even more uncivilized than its gun laws. Not that either can be easily changed, due to ineluctable facts of history and where we are now.

    Which is why I sometimes think that catastrophe is often the only saviour, because it sweeps away the old and makes desperate measures possible.

    And that’s why, if you permit the digression, the current mess of British politics offers hope, that some old kinds of junk can be ditched, which in normal circumstance would be clung to by its adherents.


  2. jonathanufi Says:

    The real problem with the Republican plan, especially the Senate plan, is the ways it changes Medicaid funding. Not only does the Senate plan seek to largely switch Medicaid to a per capita funding scheme, but it wants to tie Medicaid’s growth to the Consumer Price Index. The real damage would begin to be felt in 2025 and beyond.


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