It's a hot issue because Obamacare allows states to expand their pool of eligible Medicaid recipients. For the first three years, Washington promises to pay 100 percent of the freight for new enrollees; later, federal support would shrink to 90 percent. (Washington covers about half the cost of today's pre-ACA enrollees.)
It's as free as free money gets in this country -- nearly $1 trillion over 10 years, which leaves Republican governors with a dilemma. To snatch or to spurn, that is the question.
More than 20 states with a Republican governor or legislature have refused the new Medicaid scheme. Texas Gov. Rick Perry and Louisiana Gov. Bobby Jindal lead the pack of GOP guvs who have said no. Jindal said the so-called free Medicaid money "would cost Louisiana taxpayers up to $1.7 billion over the next 10 years and move nearly 250,000 Louisianans from private coverage to Medicaid."
Last week, the Club for Growth called out an Idaho congressman for accepting the endorsement of an industry group that supports Medicaid expansion in Idaho. Club spokesman Barney Keller told me the issue isn't exactly a litmus test, but "anyone who thinks that the feds are going to make good on their promises to pay for the Medicaid expansion" is kidding himself.
This month, Sen. Rand Paul, R-Ky., told Fox News that New Jersey Gov. Chris Christie could be sorry the Garden State is expanding Medicaid under Obamacare. "I don't think that is going to resonate in the Republican primary," quoth Paul, who himself seems eager to run in 2016.
Christie is in good company. Other GOP governors -- John Kasich of Ohio, Jan Brewer of Arizona and Rick Scott of Florida -- are taking advantage of the Obamacare Medicaid terms.At The Washington Post, Reid Wilson writes:
When Gov. Chris Christie (R) decided that New Jersey would expand Medicaid under the Affordable Care Act , he opened the door to health-care coverage for 104,000 of the poorest Garden State residents, a move he said would save the state $227 million this year alone.
But he also may have complicated his hopes of making it through a competitive Republican presidential primary in 2016, when rivals will be looking for any opportunity to distinguish themselves from the rest of the crowded field.
Christie is one of eight Republican governors to accept the expansion, including at least one other potential presidential candidate, Ohio Gov. John Kasich . The jockeying over Medicaid is a hot topic this week in Phoenix at the Republican Governors Association’s annual meeting, and it is shaping up as one of the earliest fights in the shadow campaign for the Republican nomination.
Asked by a reporter in Phoenix whether accepting a Medicaid expansion would make securing the Republican nomination more difficult, Kasich said: “Is that how you’re going to make a decision?
“Anybody who would be making the decision from that standpoint I wouldn’t want to be supporting for president,” Kasich said. “I think all things kind of fade over time.”