Governors like Rick Scott of Florida and Nikki Haley of South Carolina have made a big show over the past week of refusing the Medicaid expansion funds provided by the Affordable Care Act—a critical part of the law that would provide coverage to millions of uninsured people in poverty.
The excuses they’ve given for shunning the money, however, ring hollow. A recent study by the Urban Institute suggests that the Affordable Care Act will actually save states money, undercutting Republican governors’ arguments against accepting the Medicaid expansion. The savings come from the expansion of what is covered by the federal government and from cutting back the cost of uninsured people who need emergency care.
Urban Institute senior fellow Stan Dorn tells the Washington Post’s Greg Sargent that Medicaid expansion would help, not hurt, state budgets:
Much of the state savings we project depend on the Medicaid expansion. It’s essential to reducing uncompensated care; it’s a key piece shifting mental health costs from the state to the federal government; and it’s essential for other state savings as well.
According to the study, Wisconsin—where Scott Walker has declared he won’t accept these new funds—could save $3.7 billion over the rest of the decade. Iowa, where Gov. Terry Branstad has announced his intention to refuse the Medicaid expansion funds, could save $1.9 billion over that period.
Indeed, analysts have called the Medicaid expansion funding an “unbelievably good deal” for states. Nevertheless, many governors are plowing ahead with their refusal, spurning the chance to provide hundreds of thousands of their constituents with health insurance. And sadly, some states rejecting Medicaid expansion funds—like Florida and South Carolina—have among the highest rates of uninsured people in the country.
How many people are affected by this decision? This great interactive map explains how many people would lose out if their state governments turn down Medicaid expansion funding. There are more than 160,000 people in Wisconsin who will go uncovered if Walker follows through on his threat to cast Medicaid expansion funds aside. Iowa has more than 110,000 people who will go without coverage as a result. And in Florida, where Rick Scott has made opposition to the Affordable Care Act his signature crusade, an estimated 1.5 million people would be left uninsured by his decision.
Those aren’t just numbers on a chart. Those are human beings who are struggling, and who are just as likely to break a leg, catch the flu or develop cancer as anyone else. To the governors refusing Medicaid expansion, however, they seem to be nothing more than collateral damage of an attempt to make a political point. And as the Urban Institute study suggests, they don’t even have “we can’t afford it” as an excuse.
When we fought to pass the Affordable Care Act into law—a long, tough, and ultimately successful fight—we fought because we thought that everyone should have the chance to get health insurance, and that nobody should have to fear being wiped out by a medical problem. Governors like Walker, Scott and Branstad are putting that goal at risk.