The 14 states that so far have refused to accept Medicaid can collectively expect to lose $8.4 billion in federal transfer payments, spend an additional $1 billion in health care for the uninsured, and force 3.6 million people to remain uninsured. That's according to a
new analysis from the RAND corporation, and the conclusions are clear.
“Our analysis shows it's in the best economic interests of states to expand Medicaid under the terms of the federal Affordable Care Act,” said Carter Price, the study's lead author and a mathematician at RAND, a nonprofit research organization.
“States that do not expand Medicaid will not receive the full benefit of the savings that will result from providing less uncompensated care,” Price said. “Furthermore, these states will still be subject to the taxes, fees and other revenue provisions of the Affordable Care Act, without reaping the benefit of the additional federal spending which will costs those states economically.” [...]
“State policymakers should be aware that if they do not expand Medicaid, fewer people will have health insurance, and that will trigger higher state and local spending for uncompensated medical care,” Price said. “Choosing to not expand Medicaid may turn out to be the more-costly path for state and local governments.”
These states aren't just losing the Medicaid funding, they're possibly
increasing their own costs for covering the uninsured, all in the name of fiscal responsibility. It goes beyond simple economics, though. Refusing the expansion leaves millions in limbo, and the human cost is high. According to RAND's projections, "an additional 19,000 deaths could occur annually" in these 14 states.
One of the political questions that these governors should be forced to answer by Democratic challengers is why they are forcing the taxpayers in their state to pay for Obamacare without receiving the benefits from it. Organizing and campaigning against these governors as well as Republican legislators on the issue makes good political sense, because the good news is that a new governor, a new legislature could sign on to the expansion at any time.