Dick Morris and  Eileen McGann

The Medicaid expansion provisions of the Senate bill are complex. In the first year of the program (2013), states must enroll anyone who earns less than 133 percent of the poverty level in their programs. For a family of four, the national average poverty level in 2009 is $22,000 a year. So any family that size that makes less than $29,000 would be eligible for Medicaid. Many states, particularly in the South, actually have Medicaid cutoffs that are below the poverty level. Arkansas, for example, cuts off its Medicaid eligibility at only 17 percent of the poverty level, and in Louisiana, it goes up to only 26 percent. For these states, the spending increase required by the new bill is huge.

For the first three years of the program (2013-2015), the federal government would pay for all of the costs of the Medicaid expansion. But, starting in the fourth year of operation -- 2016 -- the average state would be obliged to pay 10 percent of the extra cost.

For Democratic governors, this provision means sudden death. Particularly in states with limited Medicaid coverage, it would require huge tax increases that would bankrupt their states. This mother of all unfunded mandates is a tsunami coming at the states as Obama tries to shift to them as much of the program cost as possible.

The following chart indicates the amount of new state money each of the 39 affected states would have to come up with apart from federal aid to cover the unfunded mandate in the Baucus or Senate version of the health care bill:

STATE SPENDING INCREASES IN MEDICAID REQUIRED BY SENATE HEALTH BILL

Alabama $394 million
Alaska 39
Arizona 217
Arkansas 402
California 1,428
Colorado 163
Delaware 35
Florida 909
Georgia 495
Hawaii 41
Idaho 97
Iowa 77
Indiana 586
Kansas 186
Kentucky 199
Louisiana 432
Maryland 194
Michigan 570
Mississippi 136
Missouri 836
Montana 29
Nebraska 81
Nevada 54
New Hampshire 59
New Mexico 102
North Carolina 599
North Dakota 14
Ohio 399
Oklahoma 190
Oregon 231
Pennsylvania 1,490
South Carolina 122
South Dakota 33
Texas 2,749
Utah 58
Virginia 601
Wash State 311
Wyoming 25
West Virginia 132

These data are rough calculations prepared under the advice and guidance of the Republican staff of the committee. The exact numbers -- which have not yet been released -- will vary due to a number of factors, some not even worked out yet in the bill. But they present a clear indication of the order of magnitude of what is coming down the pike for 39 states under this bill.


Dick Morris and Eileen McGann

Dick Morris, a former political adviser to Sen. Trent Lott (R-Miss.) and President Bill Clinton, is the author of 2010: Take Back America. To get all of Dick Morris’s and Eileen McGann’s columns for free by email, go to www.dickmorris.com