by Bob Laszewski

First Posted at Health Care Policy and Marketplace Review on 02/27/2013

Bob Laszewski, Host of Health Care Policy and Marketplace Review

The New Jersey Governor became the eighth Republican to take the Medicaid expansion deal.

What I found notable is that he essentially mimicked Florida Republican Governor Rick Scott in reserving the right to back out in future years if the feds don’t keep their funding promises. While the feds are paying 100% of the cost of expansion in the first three years, that support ultimately drops to 90% in later years.

Said Christie, “If that [the fed’s funding promise] ever changes because of adverse actions by the Obama administration or broken promises, I will end it as quickly as it started.”

One of the primary reasons some Republican governors are balking at taking the expansion is because they think Medicaid is unsustainable and the feds will ultimately have to renege on the deal.

In fact they may be right––presuming we never do anything to reform the program.

But, as Scott and now Christie have shown, they can condition their expansion on those promises being kept.

The remaining Republican governors are just plain running out of excuses for why they think it is a good idea to leave millions of people without at least basic Medicaid health insurance.

Related posts:
By Refusing to Implement the Medicaid Expansion Republican Governors May Be Making the Republican Block Grant Proposals Impractical

Florida’s Republican Governor Scott Does a Deal With Sebelius on Medicaid

Patricia Salber MD, MBA (@docweighsin)
Patricia Salber, MD, MBA is the Founder and Editor-in-Chief of The Doctor Weighs In. She is also the CEO of Health Tech Hatch, the sister site of TDWI that helps innovators tell their stories to the world. She is also a physician executive who has worked in all aspects of healthcare including practicing emergency physician, health plan executive, consultant to employers, CMS, and other organizations. She is a Board Certified Internist and Emergency Physician who loves to write about just about anything that has to do with healthcare.


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