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.

Net Loss of Federal Funds in 2022 for States That Aren't Expanding Medicaid

Where Have I Heard This Before?

From Paul Ryan's original health care proposal, which established him in some eyes as tough-minded health policy intellectual with bold and innovative solutions. Such as these:

Provides a refundable tax credit – $2,300 for individuals and $5,700 for families – to purchase coverage in any State, and keep it with them if they move or change jobs.

Provides transparency in health care price and quality data, making this critical information readily available before someone needs health services.

Creates state-based health care exchanges, so individuals and families have a one-stop marketplace to purchase affordable health insurance without being discriminated against based on pre-existing conditions.

Equips states with tools like auto-enrollment programs and high-risk pools, so affordable health coverage can be accessed by all.

Addresses health care’s growing strain on small businesses, by allowing them to pool together nationally to offer coverage to their employees.

Encourages the adoption of health information technology and assists states in establishing solutions to medical malpractice litigation.

Seems like I've heard a lot of this before...