I thought medicaid was state and medicare federal?
Isn’t it better going to the state level?
No. What Obama did was offer states $ if they allowed for more people to be ELIGIBLE for Medicaid, by increasing the income threshold for "eligibility". But the ACA was then over time going to STOP the Federal aid, and leave the rest for the States to pick up the costs.
This is why many Republican governors wanted no expansion of Medicaid, since they know how much they will be on the hook for paying.
And long before PPACA was a gleam in Obama's eye, some states had already expanded Medicaid. Like Tennessee with TennCare.
But the problem with TennCare is it's enormously expensive to run.
I forget the numbers but it is a huge chunk of the budget, and is not sustainable without large tax increases.
Now picture the same disaster nation-wide. Low tax or no-tax states are going to have to find a way to pay for this, and it will NOT be pretty.
This is the next battle and why you are seeing court challenges to ACA by individual states that want no part of this. For good reason.
Medicaid is State gov but Obama bribed the States with extra money to cover the costs of the folks enrolling in Medicaid for a couple of years. Then the States will be left holding the bag and will have to increase taxes to pay for the increased Medicaid costs. WA does not have an income tax but the progressives have been longing for one forever, so it will be a selling point to the public to install one.
Obama also robbed old folks of Medicare money to pay for the increased Medicaid costs. That’s OK tho cuz all those folks need is a pill anyway, one that removes them permanently from the SS payroll.
Another thing no one is talking about is that most docs don’t accept Medicaid because it pays so little. The quality of Medicaid docs is probably not too good and the quantity will not be able to serve the extra patients.