System Messages

state of implementation

Primary tabs

    Tracking Medicaid Expansion Decisions: A Closer Look at Legislative Activity

    *Chart updated February 7, 2014

    For 2014 legislative activity and other Medicaid expansion updates, see State Refor(u)m's Medicaid expansion map.

    At State Refor(u)m, we are continuing to track state Medicaid expansion activities. This revised chart includes additional details on key elements of Medicaid expansion bills that have been introduced in state legislatures, such as proposals to provide coverage to the expansion population through qualified health plans on the exchange, special requirements related to cost sharing or care delivery, or options allowing a state to discontinue participation in the expansion. You’ll also find direct links to statements from the governor or executive branch and fiscal and demographic analyses from the state or other institutions. This chart is a record of legislation introduced, but does not track the exact status of bills moving around in state legislatures, though we will include when bills pass chambers and/or are signed by a Governor.

    Like all State Refor(u)m research, this chart is a collaborative effort with you, the user. State Refor(u)m captures the health reform comments, documents, and links submitted by health policy thinkers and doers all over the country. And our team periodically supplements, analyzes, and compiles this key content.

    State & Status of Expansion

    Governor or Executive Branch Activity

    Legislative Activity: State Bills

    Legislative Activity: Cost Sharing

    Legislative Activity: Premium Assistance

    Legislative Activity: Special State Financing

    Legislative Activity: Severability Clause

    Legislative Activity: Medicaid Program Studies

    Fiscal & Demographic Analysis: State Government

    Fiscal & Demographic Analysis: Other

    Yes: Expansion signed into law or strong likelihood of expansion

    Maybe: Legislature still in session and/or status of expansion uncertain

    No: Not expanding or legislative session closed without passing expansion

    Statement regarding state's expansion decision from a Governor

    State bills related to Medicaid expansion in the legislature

    Requires some type of cost sharing for Medicaid expansion population

    Requires expansion population to be enrolled in plans offered in the commercial market through the exchange

    Special state financing mechanism or fund associated with Medicaid expansion

    Requires that the state discontinue participation in the expansion if FMAP reduced below a certain amount

    Requires examination of potential Medicaid reforms, sometimes as a requirement prior to considering expansion

    Conducted directly by a government agency or contracted out by the state to another institution

    Conducted by organizations and institutions independent of the state

    AL

    No

    Governor against expansion

    2014 legislative session:

    SB 92 supporting expansion

    HB 270 proposes a state constitional amendment to allow voters to determine participation in expansion

    2013 legislative session:

    SB 259 supporting expansion

    HR 176 supporting expansion

    SJR 41 supporting expansion

    F ,F

    AK

    No

    Governor against expansion

    2014 legislative session:

    HB 290 supporting expansion

    2013 legislative session:

    HCR 8 supporting expansion

    X; FMAP must comply w/ACA (HB 290)

    F, F

    F

    AZ

    Yes [1]

    Governor supports expansion

    2013 legislative session:

    SB 1492 budget bill includes support of expansion; signed by Governor

    X

    X; non-federal share funded by fee assessed on hospitals

    X; if FMAP <80%

    F,F,F

    F

    AR

    Yes

    Governor supports expansion

    2013 legislative session:

    HB 1143/SB 1020 to expand Medicaid through the exchange; signed by Governor

    HB 1219 appropriations bill to expand Medicaid through the exchange

    X

    State submitted 1115 waiver application; HHS approved waiver

    X; creates Health Care Independence Trust Fund made up of any savings accrued from carrying out expansion as outlined in legislation

    X; FMAP must comply w/ACA

    F,F,F,F

    F

    CA

    Yes

    Governor supports expansion

    2013 legislative session:

    AB 1X-1 and SB 1X-1 supporting expansion, signed by Governor

    F

    D,F

    CO

    Yes

    Governor supports expansion

    2013 legislative session:

    SB-13-200 supporting expansion and signed by Governor

    X; non-federal share funded through existing Hospital Provider Fee Cash Fund

    X; subject to sufficiency of provider fee and FMAP

    D,F,F

    CT

    Yes

    Governor supports expansion

    DE

    Yes

    Governor supports expansion

    DC

    Yes

    Mayor supports expansion

    FL

    No [2]

    Governor supports expansion

    2014 legislative session:

    SB 710 supporting expansion

    2013 legislative session:

    SB 1816 (SPB 7038) to expand Medicaid through the Healthy Florida program and managed by state's CHIP administrator

    X; also health reimbursement accounts for OOP expenses (SB 710 and SB 1816)

    X (SB 1816)

    X; FMAP must comply w/ACA (SB 710 and SB 1816)

    F, F, F,F

    F,F

    GA

    No

    Governor against expansion

    2013 legislative session:

    SR 12 supporting expansion

    HR 280 supporting expansion

    HR 107 creates joint Medicaid study committee

    X; would focus on Medicaid reform & program sustainability, including expansion issues (HR 107); signed by Governor

    F

    HI

    Yes

    Governor supports expansion

    2013 legislative session:

    HCR 147/HR 116 to support expansion up to 200% FPL

    SCR 153 to support expansion up to 200% FPL

    SCR 112 to support expansion up to 200% FPL

    ID

    No

    Governor against expansion

    2013 legislative session:

    HB 309 supporting expansion

    X

    F,F,D,D

    IL

    Yes

    Governor supports expansion

    2013 legislative session:

    HB 106 supporting expansion

    SB 26 supporting expansion; signed by the Governor

    HB 176 against expansion

    X; if FMAP <90% (HB 106 & SB 26)

    IN

    No [3]

    Governor against expansion

    2014 legislative session:

    SB 369 supporting expansion

    HB 1309 supporting expansion

    SB 370 supporting expansion

    2013 legislative session:

    SB 551 supporting expansion

    X; uses Healthy Indiana Plan model & health care accounts for OOP expenses (SB 551)

    X (SB 370 and SB 551)

    X; FMAP must comply w/ACA (SB 551)

    F

    F

    IA

    Yes [4]

    Governor supports a version of expansion

    2013 legislative session:

    SF 446 to expand Medicaid with a portion of expansion population enrolled in the exchange; signed by Governor

    HSB 232 supporting expansion up to 100% FPL

    SF 296 supporting expansion

    X; uses Governor's Healthy Iowa Plan model; uses medical home model and ACOs; health care accounts for OOP expenses and certain health services (HSB 232)

    X; (SF 446)

    X; for individuals between 100-138% FPL (SF 446)

    X; creates Healthy Iowa Account to pay for non-federal share of costs associated with Healthy Iowa Plan (HSB 232)

    X; creates an account in the state treasury, an IowaCare account, where FFP for the expansion population (along with other monies) will be deposited (SF 446)

    X; subject to availability and sufficiency of FFP (HSB 232)

    X; FMAP must comply w/ACA (SF 296 and SF 446)

    F

    KS

    No [5]

    Governor against expansion

    2014 legislative session:

    HB 2434 supporting expansion

    2013 legislative session:

    HCR No. 5013 against expansion

    HB 2032 supporting expansion

    S Sub for HB 2143 includes amendment prohibiting expansion unless approval received from legislature

    F,F

    F,F,F

    KY

    Yes [6]

    Governor supports expansion

    2013 legislative session:

    SB 39 against expansion unless authorized by legislature

    F

    F

    LA

    No

    Governor against expansion

    2013 legislative session:

    HCR 4 supporting expansion

    HB 110 supporting expansion

    HB 449 supporting time-limited expansion

    HB 233 supporting expansion

    SB 125 supporting expansion

    X; also creates health savings accounts (HB 233 & SB 125)

    X (HB 233 & SB 125)

    X; HB 449 contains option to discontinue expansion if legislature determines in best interest of state; also ends 12/31/16

    X; in SB 125 & SB 233 FMAP must comply w/ACA & expansion ends 7/1/17

    X; both HB 233 & SB 125 direct that annual report should be more comprehensive by examining health outcomes and program improvement recommendations

    F

    ME

    No [7]

    Governor against expansion

    2014 legislative session:

    LD 1578 supporting expansion

    2013 legislative session:

    LD 1066 supporting expansion

    LD 1546 hospital debt repayment bill includes support of expansion; vetoed by Governor

    X; creates fund to pool any savings (LD 1578)

    X; FMAP must comply w/ACA and expansion ends 12/31/16 (both LD 1578 and LD 1066)

    F

    F

    MD

    Yes

    Governor supports expansion

    2013 legislative session:

    SB 274/HB 228 supporting expansion, signed by Governor

    F

    MA

    Yes

    Governor supports expansion

    MI

    Yes [8]

    Governor supports expansion

    2013 legislative session:

    SB 459 expand Medicaid through exchange

    SB 460 would establish private health insurance exchanges and transfer residents currently receiving Medicaid to individual health savings accounts to purchase coverage

    HB 4714 supporting expansion, signed by the Governor

    HR 17 supporting expansion

    S 41 against expansion

    X (HB 4714)

    X; SB 459 would direct individuals between 100-133% FPL to buy insurance on FFM and those earning less than 100% FPL would be covered by the state;

    After 48 months, individuals between 100-133% FPL would have the option to either receive coverage through the exchange or remain on Medicaid but pay higher OOP costs (HB 4714)

    X; SB 459 creates a Low Income Trust Fund to collect anticipated savings from moving people to the exchange

    SB 460 creates individual health savings accounts to purchase coverage

    X; FMAP must comply w/ACA (HB 4714)

    D, F,F

    MN

    Yes

    Governor supports expansion

    2013 legislative session:

    HF 9 supporting expansion, signed by Governor

    F

    MS

    No [9]

    Governor against expansion

    2014 legislative session:

    HB 1067 supporting expansion

    HB 41 supporting expansion

    2013 legislative session:

    HB 452 supporting expansion

    HB 460 supporting expansion

    HB 1442 supporting expansion

    HB 2662 against expansion

    F

    F,F

    MO

    No

    Governor supports expansion

    2014 legislative session:

    HB 1239 supporting expansion

    HB 1608 supporting expansion

    2013 legislative session:

    HB 627 supporting expansion up to 100% FPL

    HB 700 supporting expansion up to 100% FPL

    SB 14 modifying Medicaid eligibility

    SB 349 supporting expansion

    SB 456 mandates that if expansion implemented it will discontinue 12/31/16 unless legislature reauthorizes

    SB 131 allows for expansion but requires legislature to annually reauthorize

    X; HB 700 also aligns most benefits to those provided in commercial market; also high deductible plan option

    X; FMAP to comply w/ACA (SB 349)

    X; the House creates two new panels to study potential changes to state's Medicaid program

    F,F,F,F

    MT

    No [10]

    Governor supports expansion

    2013 legislative session:

    HB 458 supporting expansion

    SB 393 supporting expansion

    HB 590 supporting expansion

    SB 395 supporting expansion

    HB 623 to expand Medicaid through the exchange

    X (SB 395)

    X (HB 623)

    X (SB 395)

    X; with some exceptions (HB 623)

    X; HB 590 creates Medicaid eligibility expansion account

    X; if FMAP <90% (HB 590)

    X; FMAP must comply w/ACA & expansion will end 6/30/17 (SB 395)

    X; FMAP must comply w/ACA (HB 623)

    X; directs state Medicaid office to review care delivery options (SB 395)

    X; directs state Medicaid office to review care delivery options & expansion implementation process (HB 623)

    F,F

    NE

    No

    Governor against expansion

    2014 legislative session:

    LB 887 supporting expansion

    2013 legislative session:

    LB 577 supporting expansion

    LB 578 creates Health Care Access and Support Fund

    X; LB 887

    X; for individuals with incomes between 100-133% FPL (LB 887)

    X; creates Health Care Access and Support Fund to in part support Medicaid expansion, funded by premium taxes on health insurers (LB 578)

    X; if FMAP <90% legislature can determine action (LB 887 and LB 577)

    X; LR241 a resolution calling for legislature's Health and Human Services Committee to study expansion

    F

    F

    NV

    Yes

    Governor supports expansion

    NH

    No [11]

    Governor supports expansion

    2014 legislative session:

    HB 544 supporting expansion passed in the House

    2013 legislative session:

    HB 271 against expansion

    X; (HB 544)

    Budget agreement establishes a study commission(see commission's final report in adjacent column)

    F,F,F

    NJ

    Yes

    Governor supports expansion

    2013 legislative session:

    S3000 budget bill provides for expansion; signed by Governor

    SB 2644 supporting expansion [12]

    SCR No. 132 supporting expansion

    NM

    Yes

    Governor supports expansion

    2013 legislative session:

    HB 2 appropriations act provides for expansion, signed by Governor

    X; FMAP must comply w/ACA

    F

    NY

    Yes

    Governor supports expansion

    2013 legislative session:

    S 2606 budget bill supporting expansion, signed by Governor

    NC

    No

    Governor against expansion

    2013 legislative session:

    SB 4/H 16 against expansion unless authorized by legislature; signed by Governor

    F

    ND

    Yes

    Governor supports expansion

    2013 legislative session:

    HB 1362 supporting expansion; signed by Governor

    HB 1012 submitted by the Governor allowing the Department of Human Services to accept funding for expansion

    Unclear; expansion implemented either by bidding through private carriers or using the exchange (HB 1362)

    X; FMAP must comply w/ACA and expansion will end 8/1/17 (HB 1362)

    X; includes a review of alternatives to ACA & expansion, focusing on health care access issues (HB 1362)

    OH

    Yes [13]

    Governor supports expansion

    2013 legislative session:

    SB 117 supporting expansion

    HB 176 supporting expansion

    HB 125 supporting expansion

    SB 166 supporting expansion

    X (all bills)

    X; a portion of Medicaid recipients may be enrolled in a waiver component that provides premium assistance for recipients to purchase QHPs through an exchange (HB 176)

    Governor has expressed interest

    X; HB 176 establishes Medicaid reform fund for federal funds received for expansion population

    X; FMAP must comply w/ACA (all bills)

    X; HB 176, SB 166

    F,F

    F, F,F

    OK

    No [14]

    Governor against expansion

    2013 legislative session:

    SB 777 supporting expansion

    SB 640 supporting expansion

    X (SB 640)

    X (SB 640)

    F, F

    OR

    Yes

    Governor supports expansion

    F

    PA

    Maybe [15]

    Governor supports a version of expansion

    2013 legislative session:

    SB 12 supporting expansion

    HR 115 supporting expansion

    Not in legislation but Governor has expressed interest

    X; FMAP must comply w/ACA (SB 12)

    F

    F,F,F,D

    RI

    Yes

    Governor supports expansion

    2013 legislative session:

    H 5127 budget bill includes support of expansion

    SC

    No

    Governor against expansion

    2013 legislative session:

    H 3710 amendments supporting expansion defeated

    F

    SD

    No[16]

    Governor against expansion

    2013 legislative session:

    HB 1205 supporting expansion

    HB 1244 against expansion

    Not in legislation but Governor appointed a Medicaid Challenges and Opportunities Task Force made up of legislators and others (see final report in adjacent column)

    F

    TN

    No [17]

    Governor undecided on expansion

    2014 legislative session:

    HB 1723/SB 1975 supporting expansion

    HB 937 against expansion

    2013 legislative session:

    HB 82 against expansion

    SB 804 against expansion

    HB 937 against expansion

    HB 290/SB 604 supporting expansion

    Not in legislation but Governor has expressed interest

    X; only as long as FMAP is at 100% (HB 1723/SB 1975)

    F

    TX

    No [18]

    Governor against expansion

    2013 legislative session:

    SB 3791 to create an alternative way to expand Medicaid [19]

    SJR 8 proposing a constitutional amendment to require Texas to expand Medicaid

    HB 999 supporting expansion

    SB 7 redesigning Medicaid services for individuals needing long term or acute care services includes amendment prohibiting expansion without legislative approval

    X (SB 3791)

    X; when cost effective (SB 3791)

    X; FMAP must comply w/ACA (SB 3791)

    F

    UT

    No [20]

    Governor supports expansion

    2013 legislative session:

    HB 153 supporting expansion

    HB 391 against expansion unless certain conditions met; signed by Governor

    X; any general fund savings from Medicaid expansion deposited into Medicaid Growth Reduction and Stabilization Account (HB 153)

    X; prohibits expansion unless review of statewide charity care system completed & analysis of expansion impact conducted & reported to legislature (HB 391)

    D, F, F, F

    F

    VT

    Yes

    Governor supports expansion

    VA

    No [21] [22]

    Governor supports expansion

    2013 legislative session:

    HB 1500 budget bill amendments provide for expansion under certain conditions, signed by Governor

    X; also aligning most benefits to those provided in commercial market

    X; creates special fund financed by projected general fund savings associated with Medicaid expansion; funds to be used for health innovation grants

    X; FMAP must comply w/ACA

    X; creates Medicaid Innovation and Reform Commission to examine possible reforms prior to considering expansion

    F,F,F

    WA

    Yes

    Governor supports expansion

    2013 legislative session:

    SB 5034 budget bill provides for expansion; signed by Governor

    SB 5894 supporting expansion

    X (SB 5894)

    X; creates hospital safety net assessment and fund designed to improve access to hospital care for Medicaid enrollees, including expansion population (SB 5894)

    X; if FMAP <90% then state can implement changes to cost sharing, benefits and/or optional programs (SB 5894)

    F

    WV

    Yes

    Governor supports expansion

    F,F

    WI

    No [23]

    Governor against expansion

    CMS approved Governor's proposal to modify existing Medicaid eligibility [24]

    2013 legislative session:

    SB 38 supporting expansion

    X; unless doing so prevents receipt of enhanced FMAP; also expansion population would receive Badger Care+ benchmark w/same FMAP conditions

    F, F

    WY

    No [25]

    Governor against expansion

    2014 legislative session:

    Draft House bill supporting expansion using premium assistance

    Draft House bill supporting expansion of Medicaid with limited benefits

    2013 legislative session:

    SF 0097 to change Medicaid eligibility levels for pregnant women and children to comply w/ACA but prevent further expansion of Medicaid

    SF0122 supporting expansion

    SF 0060 related to Medicaid program design changes

    X; for both 2014 draft bills

    X; for one of the 2014 draft bills

    X; for one of the 2014 draft bills, FMAP must comply w/ACA

    X; if FMAP <90% (SF 0122)

    X; creation of plan to implement Medicaid program redesign options, such as beneficiary health promotion incentives & potential use of managed care (SF 0060)

    F, F, F, F

    Download PDF

    Notes: 

    [1] Former state senators have formed a political committee, the United Republican Alliance of Principled Conservatives, to gather signatures from registered voters by September 12, 2013 to prevent enactment of the Medicaid expansion until approved by voters. The committee did not collect enough signatures to block Medicaid expansion in Arizona. There is also a lawsuit filed by Republican lawmakers challenging the constitutionality of the hospital assessment that is part of the expansion plan.
    [2] Two other bills introduced in Florida, HB 7169 (Florida Health Choices Plus) and SB 1844 (SPB 7144) (Florida Health Choices) would have provided a voucher to workers and/or low-income adults to try to purchase coverage in the commercial market, but no federal Medicaid funding would have been used, so they are not included above.
    [3] In September 2013 the state received federal approval of continuation for one year of the Healthy Indiana Plan (HIP), which began in 2008 and uses Medicaid funding to offer a high-deductible benefit package with health savings accounts; under the waiver extension, HIP eligibility levels were decreased from 200% FPL to 100% FPL for parents and childless adults beginning April 30, 2014, with individuals above 100% FPL being eligible for marketplace coverage. For more information, see Healthy Indiana Plan and the Affordable Care Act. Governor Pence has indicated that any expansion of Medicaid should be built upon HIP; he has begun communications with the U.S. Department of Health and Human Services about possible options.
    [4] State amended its 1115 waiver to account for SF 446, the Iowa Health and Wellness Plan; state submitted Iowa Marketplace Choice Plan and Iowa Wellness Plan waivers; on December 10, 2013, CMS approved the waivers.
    [5] Issue of Medicaid expansion is expected to be debated again when the state legislature reconvenes.
    [6] There was some dispute as to whether the governor has the authority to expand without legislative approval; in September 2013 a circuit court judge ruled that the governor has the authority to do so.
    [7] Governor LePage is considering options related to expansion.
    [8] Michigan's expansion of Medicaid coverage is contingent upon approval of two waivers; the state's waiver proposal is available here; on December 30, 2013 the federal government approved one waiver.
    [9] House Democrats proposed the Mississippi Market Based Health Insurance Coverage Plan modeled after AR's Medicaid expansion plan; legislators were called in for a special session to reauthorize and fund the state's Medicaid program before it expired; expansion was not passed.
    [10] Advocates for Medicaid expansion have filed the language of a ballot initiative with the secretary of state, a necessary step to take the proposal to voters next year.
    [11] New Hampshire state lawmakers held a
    special session Nov. 7-21 related to the consideration of Medicaid expansion; however lawmakers decided not to implement expansion.
    [12] S2644 supporting expansion was vetoed by the Governor because it did not contain an option to discontinue expansion if FMAP were reduced.
    [13] On October 21, 2013, Ohio’s Controlling Board
    authorized the spending of federal funds on Medicaid expansion by a 5-2 bipartisan vote.
    [14] A Leavitt Partners
    presentation commissioned by the governor recommended pursuing the premium assistance option for a January 1, 2015 launch. Governor Fallin is also interested in exploring other options.
    [15] Governor Corbett's
    Healthy PA plan proposes to use federal Medicaid funds to finance the purchase of private insurance coverage and will require federal approval. The proposal also includes cost sharing and work-search requirements for some new and current Medicaid enrollees. The draft plan is open for public comment until January, 13, 2014.
    [16] In January 2014 Governor Daugaard indicated he is considering alternative Medicaid expansion options and is interested in seeking HHS approval to implement a partial expansion up to 100% FPL.
    [17] Governor Haslam is considering alternative expansion options; see here and Premium Assistance column of chart.
    [18] On September 16 Gov. Perry sent a
    letter to the Texas Health and Human Services Commission (HHSC) requesting HHSC to seek a Medicaid reform waiver to request Medicaid funds through a block grant.
    [19]
    HB 3791 includes a request for federal authorization of the state Medicaid program to operate through a block grant funding system.
    [20] In January 2014 Governor Herbert indicated support of Medicaid expansion, but did not indicate which strategies recommended by a legislative task force he would support or if he would pursue other options. In November 2013 a panel of lawmakers ruled out a full expansion of Medicaid as a possible option.
    [21] In January 2014 Governor McAuliffe proposed a budget amendment which would allow him to authorize the expansion of Medicaid if a decision is not made by the Medicaid Innovation and Reform Commission by the end of the legislative session.
    [22] A
    letter from former Governor McDonnell notes that the budget of Virginia contains language outlining a series of reforms that must be completed to the satisfaction of a new legislative commission prior to consideration of Medicaid expansion.
    [23] Twenty Wisconsin counties sent a
    letter to State Health Secretary Kitty Rhoades asking that she funnel federal Medicaid expansion dollars to the counties for Medicaid expansion implementation to circumvent the Governor and Legislature's rejection of Medicaid expansion during the 2013 session.
    [24] Under the waiver approved by CMS, all childless adults ages 19-64 with income up to 100% FPL will be covered through BadgerCare Plus beginning 4/1/14.
    [25]
    HB 0203 funds a study of exchange options and includes a requirement for legislative approval of the Medicaid expansion; signed by Governor. Additionally, in Nov. 2013, Wyoming lawmakers began considering some Medicaid expansion options but will wait on making decisions until reconvening in mid-January.

    Produced by Anita Cardwell, Kaitlin Sheedy, and Jade Christie-Maples

     

    Contributions by Shuchita Madan, Medicaid Health Plans of America

    Related categories: 

    Topics: 

    Comments

    Table appears to have a disconnect between footnotes (all show as "F") and the Notes (numbered 1-20) at end. Could you resolve or clarify?

    Unless I'm missing something this information for PA is misleading. Gov. Corbet does NOT support Medicad expansion under the ACA. He supposedly has come up with his own health plan. So PA will miss out on millions of federal dollars that could expand services, increase employment in the behavioral health and physical health sector and cover many thousands of PA individuals who meet the poverty criteria but are currently without insurance. In Lancaster County, PA that is approximately 21,000 people.

    Thanks for your comment, you raise a good point and we've tried to clarify in the chart. We had noted in a footnote that Governor Corbett’s proposal would require a federal Medicaid waiver, but have now moved that information to the executive branch column and also provided further clarification in a footnote.

    Question: you reference estimates on the costs. If we examine past government estimates of costs of programs, future debt and deficit levels, future revenues . . . they are almost always wrong by unfathomable magnitudes. According to projections by the CBO done 20 years ago, we would have less than $2 trillion in national debt today and would be running budget surpluses. The CBO cost estimates for the ACA have changed dramatically, to much much higher costs, than were initially projected. In fact, every single "CBO cost projection update" on the ACA has increased the cost of this program. We are currently at costs for medicare, medicaid and even Social Security that are multiples ie. several hundred percent higher) than the estimated costs when these programs were passed/implemented. Look at the Social Security tax rates (amount as a percentage we pay into social security, initially people would pay just 1% on just the first $1,400 of their income. Today, employees are taxed at a 6.2% rate on income up to $113,000. Employers are also taxed at 6.2% on the employees income up to $113,000). Those tax rates have increased by several hundred percent since implementation of those programs.

    The Medicaid expansion, many say, costs the State's nothing. As the Federal Government funds it at 100% for a few years. After than the Federal government stops funding it at 100%, which obviously means at that point it DOES start costing the States money - and not just for 3 years, but forever.

    Even the proponents of the Medicaid expansion, when pressed have clearly indicated that States will cover the post Federally Funded 100% years by having to increase taxes to pay for it. I know, nobody likes to look at long term costs, especially when our election cycles are based on just a few years.

    The Medicaid expansion is like being given a printer for free, including supplies for three years. Then being forced to keep that printer forever and being forced to buy a certain level of supplies for that printer - forever. If somebody sent you an e-mail suggesting they had that deal for you, you would delete it, seeing that it is obviously a scam!

    Post new comment

    Post new comment

    Please log-in or register to post a comment