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ACA’s Medicaid expansion: A great deal for the states

The experts at the Center on Budget and Policy Priorities have more hard and compelling numbers on the facts surrounding the inexplicably controversial Medicaid expansion in the Affordable Care Act.

The takeaway: North Carolina (and all other states) would be foolish not to participate.

Consider the following:

  • The federal government will pick up nearly 93 percent of the cost of the Medicaid expansion over its first nine years (2014-2022), according to the Congressional Budget Office (CBO).
  • States will spend just 2.8 percent more on Medicaid with the expansion than they would have without health reform, CBO finds.
  • This 2.8 percent figure overstates the net impact on state budgets because it doesn’t reflect the large savings that states and localities will realize in health care spending for the uninsured.  The Urban Institute estimates that states will save between $26 and $52 billion in this area from 2014 through 2019.  The Lewin Group estimates the state and local savings at $101 billion.

Check out this chart:

You can read the entire post and the report upon which it’s based by clicking here.

 

 

2 Comments


  1. Joseph

    July 13, 2012 at 5:56 pm

    While I certainly believe that medicaid expansion is great for medicine, it has thus far proven to be a nightmare for NC’s mental health providers. This difference is due, primarily, to the NCGA’s decision to implement mental health, developmental disability, and substance abuse services as a Medicaid waiver “carve out”. While medical professionals are overseen by Community Care of North Carolina, MH/DD/SA professionals are overseen by “Local Management Entities” or LMEs for short. As indicated in a previous blog post, NC is touting millions upon millions in savings from medicaid waiver programs. Interestingly, no one seems to stop and ask from where these savings are coming. In 2010, the LMEs across the State that reported their fund balances held over 600,000,000.00. Some LMEs have built 10,000,000.00 administrative complexes for themselves and budgeted hundreds of thousands of dollars for offices leases and associated contracts. In addition they will require ongoing State and Federal monies for most all of their continued operations for the foreseeable future. At the same time, funding for MH/DD/SA services have been slashed or funding streams have been eliminated all together. Fewer of NC’s mentally ill will get needed services and the number of available MH providers will rapidly dwindle. Many are already calling NC’s jails and ERs the new community MH treatment centers. So all in all, while the ACA does look great for medicine, because of NC’s decision to “carve out” MH/DD/SA services, those citizens with behavioral health needs will be unlikely to enjoy the ACA’s numerous improvements in healthcare. Ivan Miller has written an excellent explanation of the vast disparity between medical care and behavioral health care which can be found here: http://www.ivanjmiller.com/disparity_action.html

  2. Doug

    July 14, 2012 at 8:11 am

    I never fail to laugh when someone like Rob says the federal government will pick up the tab on all of this new Medicaid spending like they have a big pile of money just sitting around. In actuality. the Federal government is totally broke,and will have to borrow this money until it eventually dumps the load on the states. In fact, the government is now only able to fund federal pensions,Medicare,entitlements. current Medicaid, and Social Security, and then has to borrow all of the rest including defense. Folks like Rob have to be clearly delusional if they think we can afford another 15 or 16 million people to be on entitlements.

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