Grace-Marie Turner of the Galen Institute writes today about the impact of Obamacare on state Medicaid programs. She concludes that the most vulnerable among us — the poor — are the likely losers under the massive expansion of Medicaid that’s written into the law. She predicts, among other things, shortages of doctors and longer wait lines.

In its ruling in June, the Supreme Court made it optional for states to expand Medicaid to cover new enrollees. Even with generous federal funding, several states have said flatly they cannot afford the expansion, which would cost states at least $118 billion through 2023.

They are resisting not only because of budget concerns but also because this large Medicaid expansion could have catastrophic effects on those who provide society’s health care safety net.


JLF’s Agenda 2012 has key facts about Obamacare’s impact on North Carolina’s Medicaid program, which would see 500,000 people added to the Medicaid rolls if the state goes forward with it. Agenda 2012 also offers these recommendations:

  1. Allow free enterprise to thrive. State restrictions, especially those mandated by the federal government, on health insurance and care provisions mean patients will see alternatives leave the marketplace, potentially driving up costs. Some changes the state should make are:
    • Allow individuals and businesses to purchase insurance from other states,
    • Reduce mandated benefits for insurance companies,
    • Ease restrictive licensing burdens on medical professionals, and
    • Repeal Certificate of Need.
  2. Opt out of participating in PPACA’s expansion of Medicaid.
  3. Use block grants, managed care, and financial incentives to help control Medicaid costs. North Carolina’s Medicaid program is expensive and poorly structured. Providers and patients have few incentives to deliver care efficiently, and there is insufficient attention paid to detecting and ending Medicaid fraud.
  4. Wait to implement Insurance Exchanges. Given the unreasonable time frame for setting up state-level exchanges and how many unknowns that still are associated with PPACA, the state should not rush forward to implement an expensive program it may not need.


Meantime, Rasmussen polling continues to show the majority of likely voters want Obamacare repealed.

The latest Rasmussen Reports national telephone survey shows that 52% of Likely U.S. Voters favor repeal of the law, while 39% are opposed.