What happens when you expand Medicaid?

Thirteen states have resisted the calls by special interests to expand Medicaid. They are the few, the brave, and the forward-thinking.

Simply stated, Medicaid expansion has been a disaster in every state that has attempted it. Despite this objective fact, every time another state considers expanding, the same lies are repeated—they’ll save money, more people will have access to health resources, and it’ll only add a small amount of new people to the state program. And every time, it’s a shock that those promises don’t come true.

Add a global pandemic into the mix, and states considering expansion are rushing to push their welfare programs over the cliff.

Here’s what really happens when you expand Medicaid:

Enrollment explodes

Expansion states have enrolled more than twice as many able-bodied adults than they expected to ever enroll. There are nearly 13 million men and women who were previously ineligible now on Medicaid. It isn’t an isolated incident—on average, expansion states have enrolled 110 percent more adults than expected.

Costs skyrocket

With a flood of now-eligible able-bodied adults in the system, costs run over just as quickly. Per-person costs have exceeded projections in expansion states by 76 percent, with taxpayers spending 157 percent more than state officials across the board promised. If the 13 holdout states decide to expand, that adds another $600 billion to the bill.

Hospitals close

Thanks to financial shortfalls from Medicaid expansion to able-bodied, working age adults, there has been a significant decrease in hospital bed capacity and the number of open hospitals. One of the big promises pro-expansion advocates make is that it will be a cure-all for struggling hospitals. Instead, it’s pushing hospitals to the brink. Hospitals in Medicaid Expansion states face greater Medicaid-linked financial shortfalls and have worse capacity for care. Medicaid expansion is self-destructive in normal times, but during COVID-19, it’s unthinkable.

Private insurance is crowded out

Of the able-bodied adults who are eligible for Medicaid under expansion, more than half already have private insurance. And still more are eligible for highly subsidized insurance on the exchange. Expansion crowds out private insurance, moving massive numbers of people from private coverage to Medicaid. This creates unnecessarily high costs for taxpayers.

Safety nets are destroyed

Nationwide there are more than 800,000 truly needy individuals trapped on Medicaid waiting lists, and nearly 22,000 have died while waiting for care since Medicaid expansion began under the Obama administration. Every dollar spent on able-bodied adults is a dollar that’s diverted away from the men, women, and children the program was intended to help. With every new stat expansion comes a new wave of able-bodied adults taking resources away from the truly needy.