STUDY: Wyoming Saved Itself By Not Expanding Medicaid
Recently Wyoming Liberty Group released a paper showing how Medicaid Expansion has been a disaster for Montana.
In 2016, Montana implemented its Medicaid expansion program under the Affordable Care Act, resulting in thousands of able-bodied adults joining the Medicaid program.
However, expansion proved to drastically accelerate Montana’s Medicaid spending. Just three years later, Medicaid spending comprised more than one quarter of Montana’s budget.6 In other words, in the first few years of expansion, Montana’s proportion of Medicaid spending had spiked six times as much as it had in the 15 years preceding expansion.
Unfortunately, this Medicaid spending crowded-out mean-ingful investments in other areas. For example, in 2000, K-12 education spending accounted for one in every five dollars of state expenditures.
But by 2018, this had declined to one in every seven dollars.9 The proportion of spending on higher education and transportation decreased over this same period.
MEDICAID SHARE OF MONTANA’S BUDGET SKYROCKETS
Montana Medicaid expenditures as a percent of total budgetSource: EDUCATION SHARE OF MONTANA’S BUDGET FALLS. Montana K-12 education expenditures as a percent of total budgetSource. (Wyoming Liberty Group Study).
MIT and Harvard released a report saying that expansion came at a great cost — and may not even meaningfully improve the health of the program's beneficiaries.
The federal government initially claimed that it would cover the entire cost of expansion. They claimed that by 2020, it will only cover 90% of the cost and leave states to cover the remaining 10%.
That offer sounded so good that thirty-seven states and the District of Columbia expanded their Medicaid programs. Voters in four of those states ratified expansion by ballot initiative.
But then came REALITY and the actual costs of expansion. It was predicted and warned about. Yet those who wanted expansion did not listen.
Far more people showed up to take advantage of the program than was predicted. The system in expansion states was overwhelmed.
Add to that, according to the Foundation for Government Accountability, each new enrollee costs about 76% more than projected.
States that expanded are now drowning in Medicaid bills.
In North Dakota, expansion cost 163% more than expected.
In Louisiana, it cost 115% more.
Now, about 1 in every 3 state dollars goes to Medicaid.
From 2017 to 2027, Medicaid spending for adults covered under the expansion will hit $938 billion. The federal government can't afford it and the states certainty cannot.
After all that spending it turns out there is not much benefit.
A study of Oregon's expansion of Medicaid compared the health outcomes to those who were on Medicaid in their state and found that "Medicaid coverage generated no significant improvements in measured physical health outcomes in the first two years."
What's more, many health providers refuse to see Medicaid patients because of the program's low reimbursement rates. So even with coverage, these beneficiaries struggle to secure care.
If anything Wyoming should look at the disaster of Medicaid expiation has been for states that bit on that rusty hook - and pass on it.