1. 2/21/13 Why GOP Governors Are Caving On Medicaid Expansion - Forbes
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Janet Novack, Forbes Staff
I write from D.C . about tax and re tire m e nt policy and planning.
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P ER S O NA L F I NA NC E | 2/21/2013 @ 2:48PM
Why GOP Governors Are Caving
On Medicaid Expansion
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The following is a guest 0
post by John S. Wilson,
a freelance journalist Most Read on Forbes
who writes regularly on People Places C ompanies
0 NEWS
health policy. You can
follow him on Twitter at Tw eet Live Stream: Sony PlayStation 4 Event
@johnwilson. in New York City +2 2 2 ,1 6 4 views
0
Florida Governor Rick PS4: T his Looks Familiar +2 0 5 ,8 8 8 views
Scott joined an esteemed John S. Wilson
PS4 Confirmed +1 4 0 ,9 5 0 views
group yesterday—he
0
became the seventh GOP Sony PS4 Will Have Instant Boot-Up,
governor to flip-flop and announce his support for the expansion Vita Integration, Cloud-Based PS3
Games +1 2 4 ,0 5 5 views
of Medicaid in his state. Chances are more Republican governors
will follow suit. Scott’s capitulation is particularly notable when 0 Liveblogging Sony's Playstation 4 Press
one considers the fact that he has fought the expansion from the Conference +1 0 8 ,1 9 0 views
very beginning. + show more
When the Obama administration first 0
Recom m ended American Ex porters, Mex ico Is The China Nex t Door
For + find m ore to follow
sold Medicaid expansion as a way to
reduce costs while extending insurance
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coverage to nearly 28 million people, the people, places, companies and
GOP scoffed. But Scott, who once ran the giant for- organizations that interest you.
profit hospital chain known as Columbia/HCA Sign up now »
(now HCA Holdings) did far more than scoff.
Florida Gov. Rick
Florida sued the federal government asserting the
Scott's Obamacare
Democrats’ Affordable Care Act was Janet Novack
Medicaid Mea Forbes Staff
unconstitutional and scored what now appears to be
Culpa Follow (250)
a Pyrrhic victory. Exercising some fancy legal
Bruce Japsen
C ontributor footwork, Chief Justice John Roberts concluded a I’m the Washington D.C. bureau chief for Forbes
questionable penalty on those who don’t buy and hav e worked in the bureau for more than
two decades. In recent y ears, I'v e spent much of
insurance was really a constitutional tax and the my time reporting about tax es -- tax policy , tax
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2. 2/21/13 Why GOP Governors Are Caving On Medicaid Expansion - Forbes
Supreme Court overall law was upheld 5 to 4. But in a win for planning, edgy tax shelters, tax ev asion, wacky
tax credits, and Congressional tax malpractice.
Ruling on Health Florida, the high court said the states could opt out (Think AMT and the lapsed estate tax .) I also
Reform Upholds of the Medicaid expansion—without being punished write about retirement policy and planning.
Key Benefits for by the loss of their existing Medicaid money, as the
Seniors law had originally provided. After that ruling, Scott J A N ET N O V A C K ’ S P O P U L A R P O S T S
said his state wouldn’t be participating in the Illinois Gov ernor Signs Amazon Internet Sales
Howard Gleckman
C ontributor Tax Law 1 8 7 ,1 5 5 views
Medicaid expansion.
How To Take A 1 00% Tax Write-Off For A New
Porsche, BMW or Cadillac 1 2 4 ,2 8 2 views
So what led to his change? One word: hospitals. Not
only have hospitals, on average, supported How Much Tax Will Y ou Owe On $640 Million
Jackpot? 9 9 ,1 4 5 views
expansion of Medicaid from its announcement, but
The Big Decision: When To Take Social Security
they’ve also been working overtime recently to 9 5 ,9 4 6 views
convince Republican governors and state legislators
Memo To Mitt Romney : The 47 % Pay Tax es Too
that it’s the financially smart thing to do. “If Florida 8 7 ,9 1 4 views
ObamaCare's 7 doesn’t expand Medicaid, we’re going to have the
Tax Hikes On money taken out of one pocket (by the federal MO R E F R O M J A N ET N O V A C K
Under $250,000- government), we just won’t get it put back in the
A-Year Earners other,” Tommy Inzina, chief administrative officer
A shlea Ebeling
Forbe s Staff
at BayCare Health System, told the Florida House
this week. In 2011 Florida hospitals spent $2.8
Medicare Medicaid
billion caring for the uninsured and had to write off Insurance.
the majority of that bill. That’s up from $2.4 billion www.Medigap360.com
in 2006–when 1.7 million uninsured were treated– Lowest Medigap Rates Guaranteed!
and the trend will only get worse unless more state Compare Companies & Apply. Age
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Constitutional Similarly, in South Carolina, Republican Gov. Nikki Buy them, forget about them, and never
Because The Haley’s opposition to expansion is softening as sell them.
Individual hospitals support expansion with their voices and
Insurance now their wallets; they say they’ll consider a
Mandate Is Both A provider tax to help pay for any state costs of the Who Just Made a Billion Dollars?
Penalty And A expansion. Bob Coble, a lobbyist for hospitals and
Tax. Wait...What? providers, told The State, “It would, essentially, be
Tony Nitti the health-care industry taxing itself to pay (it).”
C ontributor
So while the GOP’s statements on the expansion
may not add up, the math does. “Expansion will
Our Real-Time Billionaires scoreboard tracks
create more access to primary care providers, reduce the burden on hospitals the biggest holdings for 50 of the world’s
and small businesses, and save precious tax dollars,” said Rick Snyder, wealthiest people.
Michigan’s Republican governor, when he caved earlier this month. See who's up & who's down right now »
The federal government will foot 100% of the bill for Medicaid expansion until
2017. But even up until 2023, the Congressional Budget Office estimates
Closing Costs Calculator
states will pay only 10% of the expansion costs, or, $63 billion. As of now, 24 entitledirect.com
states are participating with another three leaning toward it. Let’s say the $63 Lower Your Closing Costs! Save 35%
billion were spread among all of these states equally (it wouldn’t be due to On Title Insurance. Get Free Quote.
population differences, but work with me here); Florida’s bill for expansion Personal Capital
during those six years would be roughly $2.3 billion, a tenth of its current www.personalcapital.com
Money & Investment Mgmt Software.
annual Medicaid expenditures. For that small price Florida would have Sign Up & Use Our Free Tools Today!
increased its Medicaid-insured population by a whopping 25%.
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3. 2/21/13 Why GOP Governors Are Caving On Medicaid Expansion - Forbes
people are eligible for Medicaid due to the looser eligibility guidelines (up to
133% of federal poverty level and–for the first time in Medicaid’s history–
inclusion of childless, non-elderly, non-disabled adults). But hospitals are
open to future cuts and understand the budget situation is always in flux.
What they’re not open to is having the next nine years look like the previous
nine.
Author’s note: John S. Wilson analyzes health policy for the Medicaid agency
of a Democratic controlled state. The views expressed here are personal and
are not those of the state.
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