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One Specific Element of the Lesser of Two Evils

Under Obamacare, Medicaid eligibility is expanded dramatically. About half of the increase in covered lives under the plan, which passed without GOP support, will result from a huge expansion of the public, single-payor program. Seventeen million uninsured, childless adults who currently do not qualify for Medicaid are estimated to become beneficiaries under the Obamacare expansion. These are the poor caught between the new income ceiling (133% of the poverty line) and the old (whatever limit each state sets. In Texas, the current ceiling for childless adults is 26% of the poverty line).

In addition, the program, like Obamacare in general, is funded mainly through tax increases on high wage earners, and is estimated to increase employment upon its implementation.

Unfortunately, when John Roberts switched sides on the GOP-appointed majority SCOTUS and upheld Obamacare, he also invalidated the requirement that states accept the new Medicaid rules, sending the decision back to the individual states. While the state with the current largest impact of the law on medicaid eligibility, Democratic- party controlled California, has already accepted the Obamacare Medicaid provision, many GOP led states, including Arizona, are considering not implementing the increased eligibility.

The study points out that by expanding Medicaid and qualifying for higher federal matching funds over the first four years of its implementation, Arizona could save $1.2 billion from the state’s general fund. Although the state would be expending more money to cover additional low-income residents, the influx of federal funds would exceed that expense. The study’s authors also used economic software to simulate the effects of three options for the state — accepting the Medicaid expansion, rejecting the expansion to continue the state’s current Medicaid policies, and continuing an amended state Medicaid policy that Arizona enacted in the midst of a recent budget crisis — and found that expanding Medicaid would impact other sectors of the state’s economy and help the state add thousands of new jobs.

Other researchers have also documented the potential cost-saving effects of expanding Medicaid in Nebraska, Oklahoma, and Arkansas. Hospital officials have also spoken out in favor of the proposed expansion, saying their hospitals could stand to lose millions if governors choose to reject the Medicaid expansion. However, despite the potential positive results in store for states that choose to expand the Medicaid program under Obamacare, some GOP governors continue to stand in the way. Republican governors in states including Florida, Mississippi, Texas, Wisconsin, South Carolina, and Louisiana have pledged to refuse the Medicaid expansion. Brewer has not publicly taken a position yet, saying she will wait to decide until after the November election.

Who are the people that will benefit from the Medicaid expansion?

The unemployed, the underemployed, the poorest in our society who do not currently qualify for coverage, those who gain jobs in the healthcare sector, poor whites, minourities, women and men.

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