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August 12, 2014 1:04 PM The Medicaid Expansion Promise

By Ed Kilgore

At WaPo’s Wonkblog today, Jason Millman cites a prominent study to knock down one of the first and most abiding Republican arguments in states that have rejected the Affordable Care Act’s Medicaid expansion: the generous federal match rate reflects a promise liberals do not intend to keep. There’s certainly no historic support for that assertion:

[B]ased on the 49-year history of the Medicaid program, that claim doesn’t hold up, according to Urban Institute researchers in a finding that hasn’t received as much attention….
Urban researchers found that of the 100-plus cuts the federal government has actually made to the Medicaid program since 1980, lawmakers just once reduced the federal share of Medicaid financing — and that was in 1981. Other federal cuts have been to services, payments to providers, or in program eligibility.

It should be mentioned that the 1981 match-rate cut (technically, a reduction in federal reimbursement for a limited period of time, not an actual change in the underlying match) was at the insistence not of deceptive liberals but of the sainted Ronald Reagan. Indeed, liberals, led by Henry Waxman, engineered a long series of “super-matches”—increases in the federal match rate for Medicaid coverage of specific services or populations—during the 1980s and 1990s.

The big thing to remember here is that liberals want expanded Medicaid coverage, and are willing to pay for it at the federal level. The whole bait-and-switch meme behind Republican resistance to the expansion at the state level lacks logical as well as historical support.

Ed Kilgore is a contributing writer to the Washington Monthly. He is managing editor for The Democratic Strategist and a senior fellow at the Progressive Policy Institute. Find him on Twitter: @ed_kilgore.

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