[NOTE: This post has been Updated twice three times]
One of the many objections to the Democrats’ health reform is that it would impose a large unfunded mandate on the states by adding substantial numbers of individuals to Medicaid. For example, three days ago the Speaker of the Virginia House of Delegates and the Chairman of its Appropriations Committee wrote a letter to the state’s two senators noting that the Senate bill “would dramatically boost state Medicaid expenses by expanding the number of people eligible.”
In the deal that was just struck, however, the feds agreed to pay for all of Nebraska’s new enrollees forever. In addition,
The federal government will also pick up the tab for all new Medicaid enrollees in the other 49 states through 2017.
That solves the unfunded mandate problem, right? Well, maybe not. As the Virginians stated in their letter, “by expanding the pool of people eligible to receive Medicaid benefits, the state’s cost share would grow by an additional $920 million between 2017 and 2019.”
Perhaps it would be cheaper for Virginia to provide incentives for all those individuals newly qualified for Medicaid to move to Nebraska.
UPDATE 1
Thanks to Robert Costa for quoting the above on the excellent National Review Online blog, Doctor! Doctor!
UPDATE 2
Now Senator Nelson has joined those who regard their proclaimed pro-life principles as “mere fundamentals,” since the language on abortion that he accepted (after being bought with additional Medicaid funds for Nebraska) is far worse than the Casey compromise he regarded as inadequate just a day ago. The Hill reports that “Sen. Tom Coburn (R-Oka.) said it is ‘absolutely fictitious’ that there is an anti-abortion provision in the Senate Democrats’ reworked healthcare reform bill.”
UPDATE 3
Sen. Nelson tried to explain his position today by pointing to the unfunded mandate of Medicaid expansion.
Gov. Dave Heineman “contacted me and he said this is another unfunded federal mandate and it’s going to stress the state budget, and I agreed with him,” the Nebraska Democrat said. “I said to the leader and others that this is something that has to be fixed. I didn’t participate in the way it was fixed.”
Apparently the need to have the unfunded mandate “fixed” applies only to Nebraska, not the other 49 states whose budgets will be stressed, even though Sen. Ben applauds himself for looking at issues “through the standpoint of Nebraska and the country.” [emphasis added]
