When the “Affordable” Care Act was passed, it expanded tax-payer funded health coverage through Medicaid. States that agreed to participate and expand eligibility would be reimbursed by the federal government at 100% of the costs with those reimbursement costs declining by 2020.
“At this point, many states have seen dramatic increases in their Medicaid enrollment levels beyond original expectations, which may pose serious fiscal consequences.
While this growth speaks volumes about the progress toward meeting the federal government’s goal of increasing the number of Americans with health insurance, it arguably falls short in addressing the financial burden to state governments.
With federal reimbursement levels declining in a few years, states have largely focused on the most economical and efficient delivery methods (e.g., health maintenance organizations) to help alleviate fiscal costs going forward. Still, budgetary pressures are likely to persist. Enrollment projections were wrong and costs have exceeded expectations. That is why more than 20 states, mostly conservative, Republican-dominated states, opted out of joining the ACA program and are now enjoying an “I told you so” moment after analyzing the program’s fiscal costs.”
Oregon Live reported on Tuesday that the state’s general fund and lottery revenues could total $23.6 billion from 2019 to 2021, a 5 percent increase from the current budget, yet the state could still go $623 million in the red, according to a tentative budget overview from the Legislative Fiscal Office and Department of Administrative Services.
And the main cause of this deficit? Rising costs for the state’s Medicaid program. From their report:
“Under the Affordable Care Act, states such as Oregon that expanded Medicaid must pick up a greater share of the cost over time. Existing taxes that fund the program are also set to wind down.”
Adding to that deficit is education costs that will increase due to the passage of Measure 98 in 2016. That will result in an increase in spending on the programs by $147 million annually.
How’s that “big f*cking deal” working out for you now, demorats?
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