State Budgets Busted By S-Chip, Medicaid Mandates

Posted on October 20, 2009

-By Warner Todd Huston

I suppose it makes it easier for Obama to claim that his healthcare policies are “revenue neutral” when the federal government just makes rules and expands healthcare services that it doesn’t fund then turns around and forces the states to pay for much of it out of groaning state budgets, but that seems like what is happening.

The Congressional Budget Office has reported that the costs of Obamacare’s mandates will fall heavily on the states . Obamacare will increase Medicaid coverage to one in five Americans, a growth from 50 million to 60 million Americans covered.

According to the CBO these unfunded mandates will cost the states an estimated $33 billion. Naturally, this estimate is likely low and costs to state budgets will be much higher in reality.

USA Today asked some pertinent questions about this unfunded increase in coverage mandated by Obamacare.

Can states afford it? Medicaid already consumes about 22% of state budgets, and 13 million people are eligible but not enrolled, the National Governors Association says. The expansion also could tempt more of those currently eligible to sign up.
Can states handle the expansion? Fourteen states, half of them in the South, only accept parents at less than 50% of the poverty level, so the expansion would be vast. Aging computer systems used to set eligibility may not be up to the task, says Ann Kohler, director of health policy at the American Public Human Services Association.
Will there be enough doctors? Many parts of the country already face an acute shortage of general practitioners, 35% of whom did not accept new Medicaid patients last year, according to the Center for Studying Health System Change. House legislation would require states to raise Medicaid payment rates to doctors, but Senate legislation would not.

The answer, of course, is that the states cannot afford it. Earlier in the year, news reports showed that 46 of our 50 states were facing budget shortfalls, yet Obama wants to force these same states to come up with billions more for his unfunded Obamacare mandates?

With most states on the verge of the equivalence of bankruptcy Washington and Obamacare will force billions more in spending on states that simply cannot afford it. And Obama calls it “reform.”

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