Type to search

Study: States That Refused Medicaid Expansion Will Lose Billions

Memo Pad National News

Study: States That Refused Medicaid Expansion Will Lose Billions


When the Supreme Court ruled in the summer of 2012 that individual states did not have to participate in a federal expansion of Medicaid, many Republican governors rejoiced. “We don’t need the federal government telling us what to do when it comes to meeting the needs of the citizens of our states,” wrote Florida governor Rick Scott (R).

Today, the financial implications of the refusal are now clear: States like Scott’s Florida stand to lose billions because of their ideological crusade against the federal government.

The pro-health care reform Commonwealth Fund released a study this month showing exactly how states will pay for their refusal to accept the Medicaid expansion. The Affordable Care Act states that the federal government is responsible for paying 100 percent of the cost of expanding Medicaid for the first three years. After that, the federal government covers 90 percent of the cost. Accepting the expansion is a common-sense economic move by states, according to the study’s authors. They write:

States that choose to participate in the Medicaid expansion will gain considerable new federal funds. States often seek to increase their share of federal funds, lobbying for military bases, procurement contracts, and highway funds. Federal funding provides direct benefits and bolsters local economies.

As the Washington Post notes, Texas will miss out on the most federal funding, but all states who refused the expansion will lose funds offered by the federal government. Louisiana, Oklahoma and Wisconsin will pass up more than $1 billion, while bigger states like Georgia, Missouri, North Carolina and Virginia will miss out on more than $2 billion in federal funds.

Nevertheless, Republican governors who lead these states are steadfast in their opposition, despite the negative economic implications.

Louisiana governor Bobby Jindal (R), for example, thinks the expansion is the federal government trying to “bully” the states. “We will not allow President Obama to bully Louisiana into accepting an expansion of Obamacare,” he said in a statement.

Similarly, Texas governor Rick Perry (R) said about the Medicaid expansion: “It’s like putting 1,000 more people on the Titanic when you knew what was going to happen.” Perry also said about Republican governors who accepted the expansion (such as New Jersey’s Chris Christie), “I think it’s a factor; I think it’s a philosophical position.”

Perhaps Christie’s decision was driven by numbers, rather than “philosophy.” By accepting, New Jersey will receive federal funds to expand the program. Texas, on the other hand, will pass up $9.2 billion in federal funds over the next 10 years.

Photo: Ed Schipul via Flickr


  1. Lynda Groom December 6, 2013

    Perhaps the folks who live in those unfortunate states will begin to pay attention, and demand some leadership from their governors instead of party driven drivel. We shall see.

    1. Independent1 December 7, 2013

      Lynda, according to an article in the DailyKos entitled: “Rick Perry in negotiations to accept Medicaid expansion.” People at least in Texas are beginning to pay attention. Here’s an excerpt from the article:

      There does seem to be a general feeling in the chamber that something is bubbling up below the surface. As I went to Republican members offices and behind closed doors there is almost a sense of foreboding on the Republican side that is palpable – and it’s not just in Austin. Another member I met with in the conservative district of Sherman which borders Oklahoma said, “ Look I’m as conservative as they come, but I’m not going out to dinner with Ted Cruz in DC, I’m not a celebrity. I got neighbors to take care of. Republicans I have known for years are signing up for Obamacare on the federal website.What in God’s name am I going to tell them come 2014, that I am going to kick them off their insurance. These same people are being asked to go to the Turn Texas Blue meetings.”
      He walked over to his large office window and pulled the curtains back and pointed, “Look at that. Those god dammed people set up right outside my office. They are registering hundreds of people a week for the Democratic party, and now they have another office on the outside of town near the damned pig farm.”
      He shook his head and walked back to his desk and sat down with an air of resignation. “Ya know, I got caught up in the Teaparty and the Perry presidential run and then the Cruz crusade, but ya know, I got people to help, who have kids to feed and grandparents to take care of, and I’m not going to let them down. I went to the local Teaparty meeting last week and ya know how many people were there ? Take a guess – there were six people there. Two years ago ya couldn’t fit them in the building there were so many of them. Hell yesterday I talked to the spokesman and he just signed up for Obamacare. I asked him what the hell are ya doing John, and he just shrugged his shoulders and said “I’m doing what I got to do, you got your insurance, just what the hell you expect me to do ?” “And he just walked away from me.
      Well why wouldn’t he, I mean they are not going to stick with us and Rick just so he can make a second run for the White House.
      Perry can’t change his mind now, so we are just going to have to change it for him. Otherwise you mark my word, we are going to get beat down the road and we are going to get beat bad, and it’s gonna happen sooner rather than later.
      This Turning Texas Blue outfit means business, they are everywhere. You won’t read about it in the national papers, but I’m telling you in our Republican caucus meetings at the State House there is a sense of panic so thick you could cut it with a knife !”

      1. Lynda Groom December 7, 2013

        Glad to hear it. Lets hope that the rest of the denier states get on board soon. Our circle of friends also includes republicans and independents and when not surrounded by ideologues they admit to having signed up as well. It has, for the most part, been an easy process here in California for them to do so.

  2. Buford2k11 December 8, 2013

    I am waiting for the new assault by the Koch boys and ALEC and the rest of the corrupt corporate population…The game is ON…these guys are the DOMESTIC terrorists that we have been warned about…They have control of over half the states, they are raping Detroit, and it is going to get worse…These guys have declared war on us, and while the pundits sit in their circle jerks, the Nation continues its decent into fascism…

  3. Socialism: Organized Evil December 8, 2013

    The liberty school knows that free men will voluntarily associate to create things greater than one’s intellect could ever design.

  4. Ann Snyder December 8, 2013

    I love the hyperbolic statements comparing Medicaid and the ACA to horrible things like slavery, Nazis, and now the sinking of the Titanic. Because I’m sure the slaves and the Holocaust victims and the drowning passengers all thought, “Wow, this is just like having access to good health care.”

  5. Liberalism is Nonsense December 9, 2013

    Although most people are not that interested in what someone else should be free to do, it is precisely because we cannot know how people will make use of their liberty that it is so important.

  6. montanabill December 9, 2013

    And for those states that do allow unfettered expansion of Medicaid, all us of paying taxes and not on it lose. The ‘Billions’ lost by states not accepting expansion are simply not spending OUR MONEY!


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.