Medicaid expansion is a central feature of former President Barack Obama’s Affordable Care Act, covering about 12 million people, while nearly 10 million others get subsidised private insurance.
If present trends continue, it’s only a matter of time until all states expand Medicaid, acknowledged Brian Blase, a former health care adviser in the Trump White House, who remains opposed to the expansion.
Medicaid expansion is terrible policy, but it is attractive to states because it’s almost all federal spending and the insurance companies and hospitals get lots of dollars when a state expands Medicaid, he said.
The federal government pays 90 per cent of the cost of covering people through the expansion, a much higher matching share than for low-income disabled and elderly people traditionally covered by Medicaid. Blase argues that’s an incentive to waste federal dollars.