Medicaid Expansion Critics Were Wrong

Feb 19, 2013

Last week, the Senate Select Committee on the Affordable Care Act heard presentations critical of Medicaid expansion -- one of the most important issues facing this year's Legislature.

The presentations concerned the experience of Maine and Arizona, both of which expanded their Medicaid programs several years ago, only to regret it. See "Medicaid Expansion Can Backfire, Witnesses Say."

Because those presentations were the last of the day, there was no opportunity for anyone to respond to them before the meeting ended. This response was issued Monday by the Florida Center for Fiscal and Economic Policy and the consumer group Florida CHAIN, both of which have issued statements of support for the expansion. The author was researcher Greg Mellowe, who works for both groups.

“Lessons” from  Early  Medicaid Expansions in Arizona and Maine  Rely  on  Misrepresentations, Ignorance of the Larger Context, and Irrelevant Comparisons

Summary: Claims by opponents of the Affordable Care Act (ACA) that the early Medicaid expansion experiences in Arizona and  Maine supposedly prove that the ACA Medicaid  expansion is too risky a proposition for Florida are unsubstantiated, irrelevant, and in fact false.  Furthermore, the  “lessons”  that  these states supposedly learned, as related by critics, are based solely on misrepresented, selective, and incomplete information. 

Specifically, their conclusions were only possible as a result of:

  • Inaccurate  portrayal of  these  expansions as vast “money pits” that far exceeded  cost projections  without reducing uninsurance
  • Deliberate  presentation of cost and enrollment data in a vacuum,  completely  ignoring consideration of events much larger than expansion, particularly overall population growth and the recession
  • Unswerving  reliance  on original forecasts  of  expansion impacts  that  contained  readily identifiable  and correctable  errors, as well  as  persistent  reference  to them  a decade later as “evidence” that  expansion  impacts cannot be projected with any reasonable accuracy

Extending Medicaid to provide much-needed health coverage for low-income, uninsured Floridians at a cost to the state of pennies on the dollar makes eminent sense for Florida.  By contrast, reliance on skewed and flawed conclusions about what occurred in Arizona and Maine makes no sense. Using such misinformation as a basis for rejecting Medicaid expansion in Florida would be both irresponsible and harmful to the state’s interests.
 
Click here for the PDF of the complete report.