Monday, December 9, 2013

Commonwealth Fund Report: How States Stand to Gain or Lose Federal Funds by Opting In or Out of the Medicaid Expansion

Abstract: Following the Supreme Court’s decision in 2012, state officials are now deciding whether to expand their Medicaid programs under the Affordable Care Act. While the states’ costs of participating in the Medicaid expansion have been at the forefront of this discussion, the expansion has much larger implications for the flow of federal funds going to the states. This issue brief examines how participating in the Medicaid expansion will affect the movement of federal funds to each state. States that choose to participate in the expansion will experience a more positive net flow of federal funds than will states that choose not to participate. In addition to providing valuable health insurance benefits to low-income state residents, and steady sources of financing to state health care providers, the Medicaid expansion will be an important source of new federal funds for states.

Complete report here.


  1. Health is the level of functional or metabolic efficiency of a living organism. In humans, it is the general condition of a person's mind and body, usually meaning to be free from illness, injury or pain.

  2. Yeah, I completely agree with you dave, you are saying absolutely right.

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  3. Abe asks the straw man question: "What should an MD do if asked how to help men with their health, if he has opinions on the topic based on experience and evidence?" Of course, that's not the situation here, is it? Peter has it just right. Most MDs would not consider it appropriate to give generalized advice regarding diagnostic tests to a broad population of men (or women).

    Abe also overstates the point of this blog post by creating another straw man: "It is insulting to suggest that everything physicians do is financially self-serving."

    As to scientific disagreements over the value of such testing, they certainly exist. Given those disagreements, is it appropriate for one physician who believes one way to, in essence, encourage a man to bypass his own MD who might believe the other way--and to do so in a public campaign enlisting the help of the man's mate? How could we consider that kind of approach to giving medical advice to be ethical, even just considering relationships within the profession? "Oh, your doctor is too stupid or ill-informed to properly advise you, so I'll get your mate to convince you to go down this diagnostic path." That's a lot different from suggesting to a single patient that he get a second opinion.

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