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Health Reform 2.0: Governors Pushing Back on Medicaid Expansion
Date:9/21/2012

overnment pays, on average, 57 percent of program costs, while states pick up the remaining share, although the state match can vary widely.

Some Say States Can't Afford Expansion, Others Disagree

Will the new expansion bust state coffers or fuel economic growth? Policy experts disagree.

"If they're very conservative, they'll say, 'Gee, when we do our estimates, we see this is going to cost us more state money.' What they fail to see is that it actually is a substantial economic boon to their states and it is perfectly conceivable that the additional revenue will actually create new taxes," Ku said.

The National Association of Medicaid Directors' Salo, however, dismissed the argument that more Medicaid spending translates into greater economic benefit because such calculations get into politics and ideology.

Florida Gov. Rick Scott, a former health-care executive, stands firm against expanding Medicaid, saying it would cost his state an additional $1.9 billion a year.

A recent analysis by the Florida Center for Fiscal and Economic Policy, a think tank and advocacy group for lower-income Floridians, concluded that the net cost of expanding Medicaid to the state's lowest-income uninsured "would be little to nothing, particularly after factoring in reductions in the cost of the delivery of 'uncompensated care' in settings such as hospital emergency rooms."

With most states operating on a July 1 to June 30 fiscal year, "any governor of either party would be smart not to go ahead" until after the election, added Edmund Haislmaier, senior research fellow for health policy studies at the Heritage Foundation, a conservative health policy think tank.

One often-neglected aspect of the Medicaid expansion is the impact on patient care.

In a recent analysis published in the New England Journal of Medicine, researchers from the Harvard School of Public Health compared health outcomes of patients in thr
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