ObamaCare’s Red State Trap

Ballot measures to expand Medicaid all but guarantee tax increases.

On Nov. 6 four states will consider ballot initiatives on expanding Medicaid: Nebraska, Utah, Idaho and Montana, the last of which would extend an expansion that is set to expire. More than 30 states have expanded the entitlement as part of the Affordable Care Act. The Republican failure to repeal the law ensured that this number would grow, and Governors of both parties are always eager to draw more money from Washington.

Proponents are working to make sure voters don’t know, but this is not about poor mothers and babies, who are covered by traditional Medicaid. Same for the disabled. Expansion extends the benefit to prime-age adults without children up to 138% of the poverty line. The feds pay more than 90% of the cost for the new beneficiaries, versus about half the tab in Nebraska for the truly vulnerable (closer to 70% in Idaho, Montana and Utah).

The perversity of spending more on childless men than pregnant women is reason enough to reject expansion, but there are others. Every state that has expanded Medicaid has blown the budget by spending more money on more people. The cost overruns are more than double on average.

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