UPDATED 7:05 p.m.: The expansion of Medicaid under President Obama's health care law will cost state taxpayers at least $118.04 billion through 2023, about twice the Congressional Budget Office estimate of $60 billion through 2021, Republican members of Congress said today.
Sen. Orrin Hatch, R-Utah, ranking member of the Senate Finance Committee, and Rep. Fred Upton, R-Mich., chairman of the House Energy and Commerce Committee, released a joint report ahead of a hearing where governors were lined up to testify.
"Governors of both political parties were clear when Congress was debating the $2.6 trillion health law that they could not afford a massive expansion in Medicaid. Washington didn't listen and plowed forward instead by putting 16 million Americans onto the Medicaid rolls to keep the federal price tag down," said Hatch. "With this report, we see the true cost to states, who are already facing a collective $175 billion budget shortfall, of this unsustainable expansion.
"Any sustainable attempt by governors to balance their budgets is undermined by the $118 billion cost of the massive growth of this federal program. It's time for Congress to peel this program back by putting states, not the federal government, back in charge."
White House spokesman Jay Carney disputed the report's findings. "It’s important to remember that the Affordable Care Act will cover the overwhelming majority of the costs associated with the Medicaid expansion and will, in fact, reduce the amounts they spend to care for the uninsured. A lot of independent experts have actually estimated that the states will have a net savings in their Medicare program because of the Affordable Care Act," he told reporters.So did Rep. Henry Waxman(D-Ca.), ranking member of the Energy and Commerce Committee. "All of these estimates overstate state costs because they do not include savings from reductions in states’ payments for uncompensated care. For hospitals alone, the spending for uncompensated care in 2009 was estimated to be $40 billion," Waxman said in a statement. He also said the Republican report "cherry picks" estimates from different sources.
According to the report, adding new Medicaid enrollees under the law will cost California $19.4 billion from 2018 to 2023 and will cost Florida $12.94 billion from 2013 to 2023. It uses a variety of sources including state estimates.
"Rather than ensuring the Medicaid program remains fiscally sustainable, the Patient Protection and Affordable Care Act (PPACA) enacted the largest expansion of the entitlement program since its inception in 1965. In fact, half of the individuals gaining health care coverage under the new health law will obtain it through the government’s Medicaid program," the report reads.
This article appears in the March 1, 2011, edition of National Journal Daily PM Update.