Type to search

Medicaid Projections Get More Affordable, And Obamacare Politics Get Trickier For GOP

Memo Pad

Medicaid Projections Get More Affordable, And Obamacare Politics Get Trickier For GOP


The Affordable Care Act’s Medicaid expansion is an even better deal for the states than previously thought, according to the latest estimates from the Congressional Budget Office — and that could seriously complicate Republican hopes of winning a Senate majority in November.

As the Center on Budget and Policy Priorities’ Edwin Park explained in a blog post on Tuesday, the new estimates lay waste to the GOP talking point that Medicaid expansion is unaffordable:

  • CBO now estimates that the federal government will, on average, pick up more than 95 percent of the total cost of the Medicaid expansion and other health reform-related costs in Medicaid and the Children’s Health Insurance Program (CHIP) over the next 10 years (2015-2024).
  • States will spend only 1.6 percent more on Medicaid and CHIP due to health reform than they would have spent without health reform (see Figure 1). That’s about one-third less than CBO projected in February. And the 1.6 percent figure is before counting the state savings that the Medicaid expansion will produce in state expenditures for services such as mental health and substance abuse treatment provided to the uninsured.

CBPP chart

The CBO’s revision, which represents the latest in a string of good news for the health care reform law, create a political dilemma for several Republican Senate candidates who have spoken out against expanding Medicaid. In Louisiana, for example, Rep. Bill Cassidy (R-LA) — the top Republican challenging incumbent senator Mary Landrieu — has vehemently opposed the measure, claiming that it would “bankrupt states.”

The Affordable Care Act is certainly a liability for Landrieu — polls tend to find that vast majorities of Louisianans disapprove of the overall law — but individual measures such as Medicaid expansion are a different story.

Over the past several months, Louisiana’s Republican governor, Bobby Jindal, has faced a sustained campaign criticizing him for refusing to accept Medicaid expansion, which would allow 240,000 Louisianans to obtain coverage. In a Tuesday interview with The Washington Post‘s Greg Sargent, Senator Landrieu revealed that she will try to turn the movement against Cassidy as well.

“That would be a real setback for the people of Louisiana, many of whom are working 30, 40, 50 hours a week but find themselves caught in the Jindal gap because the state refuses to expand health care options to the working poor at little to no expense,” Landrieu told Sargent, referring to Jindal’s refusal to accept Medicaid expansion.

“This issue is not going away — it will become an issue in the 2015 governor’s race,” she added. “Cassidy has wrapped himself up with Jindal. The question is whether people who work full time or part time in the U.S. should have access to quality and affordable health care.”

Landrieu’s political calculus is clear: As unpopular as President Obama is in Louisiana, Jindal is even more reviled (a recent New York Times/Kaiser Family Foundation poll found their approval ratings at 42 and 40 percent, respectively). Every bit of news that makes Medicaid expansion seem more reasonable hurts Jindal — and if Landrieu is successful, every bit of news that hurts Jindal will hurt Cassidy. It’s a formula that other red-state Democrats are likely to follow.

Photo: Gage Skidmore via Flickr

Henry Decker

Henry Decker was formerly the Managing Editor of The National Memo. He is currently an Online Associate at MRCampaigns.

  • 1


  1. ModDem67 April 23, 2014

    So, the GOP put all of their election eggs in one basket and that basket has a hole that is getting bigger and bigger. I think the GOP needs new strategists.

    1. Mark Forsyth April 24, 2014

      The gop needs to fly up its collective butt and disappear!

  2. gmccpa April 24, 2014

    “polls tend to find that vast majorities of Louisianans disapprove of the overall law — but individual measures such as Medicaid expansion are a different story.”

    The problem for the Democrats is not that vast majorities disapprove of Obamacare. They disapprove of what they THINK (or what they’ve been told) is Obamacare. When asked about each provision on its own….the law gets much more support.

    The Democrats let the RW dictate the narrative over the past four or five years. Its time for Dems them to stand up and embrace the law….and shove all the positive news down the throat of the entire RW. All the BS that the RW ranted about….where is it? Death panels? Economic collapse? Unemployment? Doctors retiring en masse? etc. Their entire opposition was (is) based on lies. Published, quotable lies. Make them own all of it.

    1. ps0rjl April 24, 2014

      I couldn’t agree more with you. Make the naysayers own everything they have said. Then point out the truth to the people. The ACA is not going away. There are flaws in it that need to be fixed but it is not going away. Throw the oppositions’ lies and half-truths back in their faces. Don’t let them wiggle out of this.

    2. Independent1 April 24, 2014

      Given that America’s media thrives on negative news, the Dems have to start pounding away on the GOP with all the downside news it can related to the GOP not supporting the Medicaid expansion.


      the fact that 7-17,000 people are projected to die in the next year due to the lack of adequate healthcare because the GOP in 24 states haven’t expanded Medicaid

      the fact that hospitals are closing in many red states that are not supporting the expansion which has already resulted in people dying that have been in accidents or medical emergencies because trips to the hospital have become too long in some areas.

      the fact that some states will actually be losing money because Medicaid expansion would have reduced their costs for providing healthcare to the poor .

      and whatever other negative news that can be compiled; not only related to the Medicaid expansion but also any other political topics that the GOP is on the wrong side of.

      1. Allan Richardson April 25, 2014

        “Democrat war on undertakers?”

    3. mamasnothappy1 April 25, 2014

      Why do we continue to pay Congress through 50 attempts to repeal the ACA? Those voting for the repeal should not be paid or fined for wasting our tax dollars. Imagine if Congress were actually working to solve the many issues facing Americans today? How much does it cost each time they try to appeal it?
      Can we make a law to stop the liars? Why are we allowing these politicians and their posses to poison every election with money donated by corporations who are charging higher prices to hire lawyers, lobbyists and paying billions to air, print and advertise lies? With no repercussions at all? Just like a false witness, these people should serve the most severest sentence possible. Mudslinging is making America appear weak. Thank you GOP.

  3. paulyz April 24, 2014

    More people getting Medicaid by taxing others more in an already broke system is a success? Nice try on the SPIN. The longer Obamacare is in existence, the costlier it will become and already has gone WAY over costs by 3 times what was projected. The ACA is hurting the Middle Class as much as the long term bad economy & unemployment…….

    1. A_Real_Einstein April 24, 2014

      My premiums went down $110.00 per month and my preventative care no longer has a copay. I cant be cancelled and my daughter will never lose her coverage due to her pre existing conditions. Our doctor is still is our doctor. What are you talking about? Costs 3 times more than projected? Source please?

      1. latebloomingrandma April 24, 2014

        I imagine the source is FAUX or Brietbart.

        1. ralphkr April 24, 2014

          Yeah, they are always good for fun “facts” (you forgot, to mention WND).

    2. jmprint April 24, 2014

      The ACA is not hurting the middle class, to the contrary.

    3. robertbenefiel@att.net April 24, 2014

      A number of my right wing friends have obtained health care under Obama Care and they do not even know that is why they have coverage

      1. Allan Richardson April 25, 2014

        SO TELL THEM ALREADY! As often as the topic comes up!

        “I like this Senator X who voted against Obamacare.”
        “Oh, you mean the plan that saved YOU money on your health care insurance?”

    4. Independent1 April 24, 2014

      Sometimes I wonder if you even have half a brain. Not only is what you post virtually always a lie, it’s virtually always wrongheaded.

      Here’s an article from the Huffington Post from 4/14/2014 that says Obamacare will cost $5 billion less this year than was originally projected while covering more people than the original estimate.

      Guess your ‘WAY over costs by 3 times what was projected” was just one of your little mental lapses – if you have anything mental in that head of yours to even lapse:

      WASHINGTON — The Congressional Budget Office has released updated estimates on the Affordable Care Act’s impact on both the budget and the health insurance industry. The findings show that the president’s signature health care law is actually growing cheaper to implement, costing the government $5 billion less in 2014 than was previously projected. The law also is projected to cover more individuals than previously believed, owing, in part, to some broader workforce trends.

      The cost of the health care law is falling, according to the CBO. Between 2015 and 2024, the price tag of Obamacare will be $1.383 trillion, $104 billion lower than prior estimates. This is because of a combination of factors, including a reduction of $165 billion in the gross costs of coverage (the government will spend less on exchange subsidies) and fewer people and businesses paying penalties for either not purchasing coverage or not providing it to their workers.

    5. Independent1 April 24, 2014

      Here’s a little article you might enjoy reading in your spare time (I assume you are literate enough to read). Unfortunately, the topic may not be of great interest to you, since it basically trashes Republicans. But you might learn something about just how inhumane Republicans have become:

      Americans Are About to Discover That the GOP Not the ACA is Hazardous To Their Health

      Here’s the lead in to the article:

      When Americans think back on historically evil and depraved human beings, they may think of Adolf Hitler, Josef Stalin, or even Osama bin Laden for their profound immorality in wantonly taking human life and creating terror. If the American people took stock of the Republican Party over the past four years and considered the terror and distress they have caused tens-of-millions of American citizens, it is likely they would conclude that, as a group, conservatives are as depraved, wicked, and inhumane as any of history’s human monsters. Whether it is deliberately withholding food, shelter, or medical assistance from people in need, there are no bounds Republicans and their conservative activists are unwilling to cross to inflict damage on Americans. As the government runs out of money to operate and its ability to borrow to repay Republican debts looms, the true extent of the GOP’s malicious nature is becoming clear.


    6. Independent1 April 24, 2014

      Seeing as how you seem to have a propensity for trashing Obamacare and anything the Dems seem to want to do. I thought this might be a good time to “trash” the GOP.

      Here’s another winner for you!!

      GOP May Be Required By Law
      To Post A Warning Label
      Patterson, N.J., Sept. 31, 2012

      Atavistic Laboratories of Patterson, New Jersey has finalized weeks of research on hazardous and dangerous materials and organizations. The GOP, they say, “”is more dangerous than tobacco, agent orange, RoundUp, radioactivity, Vlad the Impaler, Croesus, Viking Berserkers and Genghis Khan’s Golden Horde– combined.”” A spokesman for the laboratory suggested that “”Satan himself would be hard put to equal the infernal effects of the GOP.”
      The renowned international testing and assessment lab concluded research after an intensive study of the effects of Republican administrations. “The record is undeniably clear,” they say, “thousands of Americans are pushing up daisies solely because of Republican administrations, trillions of dollars have been and continue to be funneled into Swiss bank accounts, derivatives, defense industries, and ponzie schemes like bank failures and corporate educational systems.”


      1. Allan Richardson April 25, 2014

        Sometimes I get the feeling that Satan has sold HIS soul, and the title to Hell, to the Republicans, so he works for THEM now.

    7. Independent1 April 25, 2014

      And let’s just post one more article to blow a hole in your lie about ACA hurting the middle class. This article was from almost 2 months ago, but even back then ACA was freeing up so much money for people because of lower premiums and insurance companies paying for hospital and doctor visits that middle/lower class folks were having to pay for before, that ACA was even on March 4 helping boost the economy!!

      See this clueless!!

      The Affordable Care Act, President Barack Barack Obama’s signature health law, is already boosting household income and spending.

      The Commerce Department reported Monday that consumer spending rose a better-than-expected 0.4% and personal incomes climbed 0.3% in January. The new health-care law accounted for a big chunk of the increase on both fronts.

      On the incomes side, the law’s expanded coverage boosted Medicaid benefits by an estimated $19.2 billion, according to Commerce’s Bureau of Economic Analysis. The ACA also offered several refundable tax credits, including health insurance premium subsidies, which added up to $14.7 billion.

      Of course it’s helping consumers. It was designed to. Which also means it will help the economy when those consumers have a little bit more personal income to spend out in the marketplace. It will help insurance companies who will have more customers, many of whom won’t ever require big payouts. That’s one of the reason this model of health insurance reform was proposed first by conservatives!

    8. Patricia Robertson April 27, 2014

      People complained before the ACA that they wished someone would do what this president did. well the republicans came up with a plan but they could get it too pass, along came this black president, who tweaked the same plan, tried to included some better ideas in the plan to please the republicans and the republicans still wasn’t pleased even after they asked for them, so the president gave up and settled for what we have now. This isn’t perfect but it passed and courts upheld, this president was elected twice because they the ACA. The republicans decided they didn’t wanted because they knew it would do all the things they had wanted to do and they could not get passed so they got mad about. So now they have been like spoil children and mad every since and against even renamed it obamacare and now they are upset about that too. They thought no one would apply for it, billions did, they say the roll out would never happen, there were glitches on rollout day, but it got fix, then they say they would never met goal, they did, 7.5 million and counting. so people signing up because they want too.

  4. Lovefacts April 24, 2014

    In my city of 60K in central VA, our hospital has said for 2014 they’ll lose $23M because Medicaid hasn’t been expanded, and each year will be worse. It’s time Democrats took a leaf out of the Republican play book and fund raise from every hospital in a red or purple state that refused to expand Medicaid for money. That way the state parties would have sufficient money to support candidates running for local, state, and national office.

  5. Patricia Robertson April 24, 2014

    The people don’t actually hate the president they are told they are supposed to hate the president so they sure we hate him because he is black. Yet the majority of the american people who claim they hate elected him twice to be president and they knew that he was going to fight for the ACA so that is a no brainer. So it is here the people did want it for years and this president did manage to get it across the finish line where others had failed, so help him improve him and continue to make it better not work against it. Republicans should know everytime they work against something it stays around that much longer no matter how much whinning they do. There are a few small group of people who actually believe that republicans will keep them from losing their ss , medicare, medicaid, food stamp, ACA while taking it from the rest of people that is why they are smiling and happy with Ryan budget, but when they wake up and find out they are out in the cold with the rest of the people guess what they will do? Look stupid, and pitch a fit and blame the president for them being dumb, lol. So keep hating the president while you keep following the people who are laughing are you.

    1. Allan Richardson April 25, 2014

      Some of the Republicans are still angry at Lincoln for confiscating their ancestors’ “property.”

      1. Patricia Robertson April 27, 2014

        Yes and that is the problem now, that is why they love to say that blacks is lazy, dumb, and stupid. That is the same thing the slave owners said thinking the slaves would come back because of the shame but it only made the slaves that more determined to work harder to stay free. They had help to learn to read, write and the skills that they learn from their masters they improved and made them better. Same thing today blacks work hard getting education, working two sometimes three jobs to make ends determine to prove a point to who? The same people that the slaves did, The white man, People pretended for years that things were changing until the president was elected and then genie came out the bottle and now it trying to destroy the american people. We can’t let that happen, we can’t let a very people who still leave in the past let this happen, we have to stop it. We have to vote them out and we need to make sure people get to voting polls every election to make this happen.

  6. robertbenefiel@att.net April 24, 2014

    I am glad that the red states have refused the money so that the blue states can reap their money. Their medical facilities are poor in the red states and they will continue to go further South. Just think of this. Have you ever heard someone becoming really sick and saying, you know, I will head South to get treatment for my illness ?.

    1. Allan Richardson April 25, 2014

      In a few cases yes: Emory University, Vanderbilt, the CDC, Mayo Clinic in Jacksonville, Shands Hospital in Jacksonville and its original location in Gainesville (part of the University of Florida College of Medicine; Go Gators!).

      But the people in the Southern states who refused Medicaid, the poor people who foolishly voted for those Republicans, and the poor people the Republicans are trying to stop from voting against them, all groups have people suffering and dying because of this.

      The Mike Lukovich cartoon Wednesday (4/24) in the Atlanta Journal and Constitution portrayed Death walking past Governor Deal’s office with a Deal re-election sticker on his scythe. Inside, Deal was celebrating his two big “accomplishments:” Medicaid refusal and the Guns Anywhere law.

  7. Independent1 April 25, 2014

    Here’s a recent article (dated 4/15/14) with a graph from the CBO that shows how the baseline of healthcare as improved since ACA was enacted back in 2009. It shows clearly that ACA is working.

    Title of the article is:

    New CBO report on Obamacare giving Republicans heartburn

    Here’s some excerpts:

    Why does the CBO Report conclude the Obamacare numbers are improving?

    The reductions in estimated federal costs are the net result of a combination of factors. The current projections:

    Incorporate the economic forecast that CBO published in February 2014; because the projections of the effects of the ACA’s coverage provisions published in February were partial and preliminary, they did not incorporate the economic forecast published by CBO at that time.

    Incorporate further analyses by CBO and JCT of exchange premiums and the characteristics of exchange plans.

    Include revisions to estimates of the number of early retirees with employment-based coverage under the ACA.

    Account for regulations and other administrative actions that were put in place between early December 2013 and the end of March 2014.

    President Obama has always made a moral case for affordable healthcare. He also made the case that unless the cost curve of healthcare was flattened, exploding deficits would continue. As the CBO Report shows, that curve is flattening.

  8. Coffee Fiend April 26, 2014

    Obama is a destructive force.


Leave a Comment

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.