In a controversial (and possibly illegal) move, Ohio’s Controlling Board voted to expand Medicaid coverage in the state to adults that were not previously eligible by way of accepting billions in federal funds. That means 25 states, plus the District of Columbia, have now signed on to take part in an aspect of the Affordable Care Act that is both optional and ill-considered. More states are expected to follow suit, even some that, like Ohio, have Republican governors and conservative legislatures.
This is bad news. Medicaid, the nation’s health care program for low-income citizens and those with certain disabilities, is expensive. States are not required to participate in the program, but all do, though eligibility requirements differ from state to state. In 2011, states devoted nearly 24 percent (PDF) of total spending to Medicaid—the single largest state expense—despite the fact that there’s little evidence that it actually improves the health outcomes of its beneficiaries.
You got that? One of the major tenets of Obamacare is to expand an existing program that is both hugely expensive and massively ineffective.