Friday, August 30, 2013

No Turning Back on Obamacare’s Medicaid Expansion

NewscomMany states have chosen to take Obamacare’s Medicaid expansion expecting they can get out later if they wish. But that’s not the case.
Some states have said that if the federal government ever reneges on its promise of enhanced funding in the future, they’ll just withdraw from the expansion. But new legal analysis by the Buckeye Institute, an Ohio-based state think tank, shows there are both legal and political reasons why Obamacare’s Medicaid expansion is likely to be permanent.
While many states have already signed up for the expansion using this flawed backup plan, Ohio is still in a heated debate regarding expansion, and this idea is being used to garner support for it. For instance, one proposal would “create a ‘circuit breaker’ that would automatically roll back the expansion if the federal government didn’t stick to its end of the deal.”
Buckeye’s paper lays out the following reasons expansion is likely to be a permanent—once a state agrees to it, there might be no turning back.
Legal Barriers: When a state agrees to adopt Obamacare’s Medicaid expansion, it must amend its state plan, which is a contract between the federal government and each state governing the conditions of its Medicaid program. As the report explains, “Once the state plan has been amended to include the expansion, that agreement becomes part of the legally enforceable state plan contract. A state must be in compliance with its own state plan. The federal government enforces compliance by withholding federal funds. The mere threat of withholding federal dollars can generally ensure compliance.”

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