Wisconsin Gov. Scott Walker split the baby. He proposes moving 77,500 people off Medicaid and into private subsidized plans. He also would enroll new people into Medicaid with ACA dollars. "Some governors chose not to take the expansion. Some chose to take it," Walker told Politico. "I wanted to find a way to reduce the number of people who were uninsured and still do something in a way that did not put my taxpayers on the hook."
Given problems Cheeseheads are having signing on to the federal exchanges, Walker has put his "smarter, simpler and better" plan on hold.
I don't see the Obamacare Medicaid money as free. In three years, states will have to pay up. Washington could cut federal payouts. Also, seeing as states underpay providers, more Medicaid recipients could mean longer waits to see a doctor. Still, a governor is elected not to run for the White House but to do what's best for his state. How can groups such as the Club for Growth expect elected officials to say no to what their constituents see as free money?
"That's why the left loves Medicaid," responded health care wonk Michael F. Cannon of the libertarian Cato Institute. "It's socialism on stilts. You've got a program where each side" -- state and federal -- "contributes half the money (and) each side has enormous incentive to expand it." If there's fraud or waste, the federal government pays for half of that bad spending -- and all of it for new Obamacare enrollees -- and state politicians reap all the benefits.
Cannon doesn't trust Washington not to cut subsidies tomorrow that it promises today. GOP governors, he warned, beware.
"When this law passed, no one thought there would be this much resistance to the Medicaid expansion," Cannon continued. Though he found it predictable that some GOP governors signed on, "what is amazing is that so many states have said no. That's the story."