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-- to expand or not to expand out of the question facing the nation's governors as it comes to the president's health care overhaul.
State accepting the Medicaid expansion receive 100%.
Reimbursement from the federal government.
For all new enrollees but that's just 12016.
Federal -- that declines to 90%.
But by accepting the expansion states are opening themselves up to millions more people.
We'll be eligible for Medicaid in states -- receive any additional federal assistance for current Medicaid recipients.
Trendy try yeah.
-- institute senior fellow and he joins me with more -- whether the expansion is worth it in the long run.
So what's the downside to not doing the expansion as we are really crunching the numbers ahead of time and it seems like you do the expansion.
It's -- across the state money for sure over time.
What's the downside to not doing it.
I'm not sure that the state should do it first call but -- a downside to not doing it.
Is that there there's a lot of people who are uninsured in the states and there's a lot of pressure from the providers in the states particularly the the hospitals.
We're telling governors you've got to do this you gotta do -- -- with more money from the federal government.
And while in the short term they've got that 100% in the 90% match the governors are worried about long term whether that.
Will still be there or whether they'll be left.
Holding the bag but the providers and being in the hospital saying looking down the -- worried about that men now in the short term you should take the money and you should.
Yeah cover more people in -- state.
We loved to worry about down the road later I mean that's that's our favorite thing to do in this country right now we're looking at dramatically at this stage and it it's still look different colors -- it's showing you.
Basically the indecision about the nation -- -- -- people have decided to accept to not accept their lean one way they're leaving the other.
It seems like the country's very confused as to what to do.
I mean the obvious downside to accepting the expansion.
Is that it's a 100% right away and then you've got to pay at least that 10% down the road and I'm not even sure that's the end of the costs.
Yeah affect Florida's department of economic and demographic analysis to this report that was just out today may look at seven different scenarios.
And one of the things that they look at -- throughout -- that you basically are seeing.
State costs to Medicaid going up.
State will have to pay more money in Medicaid in the future and it varies depending on the -- -- scenarios but the states are going to be.
Paying more in the future and if that 90% match goes down even further which I think it well and CBO former directors like Doug -- -- has said it -- And and and I think they're going to be paying me even greater share of the future.
They still incur costs -- and if you don't take the federal money and you don't put these people on to you know the overall federal health payroll so to speak.
They're still going to emergency rooms and they're still incurring costs that are getting paid so it's not like.
They're not racking up bills if they're not in the system right.
Yeah that that's true you're talking about the issue of uncompensated care and the Florida study looked at that and assume that in whatever scenario they're still gonna be uncompensated care so -- Obama promised that.
We get this in new bill through his that is Affordable Care Act.
And now we're gonna take care this issue of uncompensated care in any scenario we're still facing large numbers of uncompensated care cross country.
So -- to advise a stay right candidates trying to figure out what to do what would you tell them to do on this let's try says.
Yeah also allows for the State's other Republican governors in -- states are saying.
No to this state exchanges and are more likely to say yes to Medicaid expenses what -- Doing what I've art argued for is that they should ban together.
And create some leverage not by going governor by governor but they saying here there's thirty Republican governors we should stand together and say.
These are the changes we need these in the guarantees we needs.
In order to go forward Medicaid expansion -- to go forward with the the state exchanges if you do those things then we'll go forward -- proceed.
Interesting wanted to watch tribute right thanks for coming on heavy -- start up that that's coming.
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