North Carolina and the other 17 states that have not expanded their Medicaid program are running out of excuses from an analytical standpoint, according to a leading health-care law expert.
Mark Hall, a law and public health professor at Wake Forest University, released last week a study titled “Do states regret expanding Medicaid?”
…The main argument against Medicaid expansion, shared by several N.C. Republican legislators leaders including Speaker pro tem Phil Berger, R-Rockingham, is that the federal government may not fulfill its pledge of covering 90 percent of the administrative costs of expansion.
They say they don’t want states to be unnecessarily vulnerable to picking up more than 10 percent of the costs.
“The strong balance of objective evidence indicates that actual costs to states so far from expanding Medicaid are negligible or minor, and that states across the political spectrum do not regret their decisions to expand Medicaid,” Hall said.
For example, Hall cites reports that several red or purple states — Arkansas, Indiana, Kentucky, Louisiana, Michigan, Montana, New Mexico, Ohio and West Virginia — “have actually reduced, not increased, state spending as a result of expansion.”
Part of the spending decrease comes from smaller-than-expected enrollment in recent years, particularly in Indiana, North Dakota and Ohio.
“None of those states that had legislative ‘triggers,’ allowing them to roll back expansion if projected costs turn out to be seriously wrong, have felt the need to pull the plug on expansion,” Hall said….
“Claims are not well founded that Medicaid expansion will cost states considerably more than what objective analysts project,” Hall said.
“Instead, those claims are based on sources that are either incomplete, inaccurate, misleading, or out of date in various ways.
“The probable costs appear to be quite low in comparison with the economic and public health benefits of expansion,” he said.