The Affordable Care Act, commonly known as ObamaCare, gives states the option to expand Medicaid to a new class of able-bodied, working-age adults. Before this, Medicaid eligibility was traditionally reserved for the truly needy, such as seniors, individuals with disabilities, and low-income kids.
States that have expanded their Medicaid programs under ObamaCare have witnessed skyrocketing enrollment and massive cost overruns. States have signed up more than twice as many able-bodied adults as initially projected. In many cases, more able-bodied adults signed up for the programs than state officials predicted would ever even be eligible. Worse yet, the per-person price tag has been nearly twice as high as projected, compounding the cost overruns even further.
Some states have adopted “conservative” ObamaCare expansion models, such as the private option model adopted in Arkansas, Iowa, and New Hampshire. Originally crafted by a Democrat Arkansas governor and the Obama administration, the private option approach to Medicaid expansion—giving Medicaid expansion enrollees insurance plans that are purchased through the ObamaCare exchange and paid for with Medicaid dollars—has proven to be a political lightning rod, failed to increase competition, led to skyrocketing costs, and increased premiums in the private market.
This model has failed everywhere it has been tested and has proven to be nothing more than a more expensive way to expand ObamaCare. Moving forward, the Trump administration should reject future attempts to replicate this model in other states.