Lawmakers should not opt-in to ObamaCare’s Medicaid expansion

Jonathan Ingram

Director of Research at Foundation for Government Accountability. Lawyer. Libertarian.

Jonathan Ingram
July 16, 2012

Lawmakers should not opt-in to ObamaCare’s Medicaid expansion

Now that the dust has settled from the Supreme Court’s ObamaCare decision, states are trying to decide whether they should opt-in to ObamaCare’s massive Medicaid expansion. Just 10 states have committed to expanding Medicaid, with another three leaning toward implementing the expansion. Leaders in 13 states, including those run by both Republicans and Democrats, have...

Now that the dust has settled from the Supreme Court’s ObamaCare decision, states are trying to decide whether they should opt-in to ObamaCare’s massive Medicaid expansion.

Just 10 states have committed to expanding Medicaid, with another three leaning toward implementing the expansion. Leaders in 13 states, including those run by both Republicans and Democrats, have said that they will not expand Medicaid, or are leaning toward not expanding the program. The remaining states have been non-committal and most are studying their options.


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Illinois should join the growing number of states who are not to opting in to the massive expansion of Medicaid. The Medicaid expansion is unaffordable and, ultimately, it hurts the very people Medicaid was meant to protect: the most vulnerable.

The program is already on the verge of collapse. Ballooning enrollment has forced the state to turn to low reimbursement rates and long payment delays to make ends meet. This has pushed more and more doctors to turn away Medicaid patients. The problems were so bad that a federal judge actually required Illinois to study the huge access barriers Medicaid patients face. The results of that study were published last year in the New England Journal of Medicine. Researchers found that children with throat cancer were denied appointments with a specialist two out of three times when on Medicaid. For children with epilepsy or juvenile diabetes, the odds of getting an appointment were 50/50. And even when they could get appointments, they usually had to wait weeks or months just to see the doctor.

ObamaCare’s massive expansion of Medicaid would dump millions of new people into a broken system, forcing the most vulnerable to compete with millions of new people for appointments with fewer and fewer doctors willing to see them. The program is already failing to provide access to quality care for our neediest citizens. Adding millions of people to that failing program will only make things worse.

Lawmakers in Illinois should join the growing chorus of lawmakers across the country refusing to opt-in to ObamaCare’s (now-voluntary) expansion of Medicaid. The Supreme Court confirmed that the states are in fact separate and independent sovereigns. It’s time we act like it.

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