PREMISE: Medicaid was operating well and could easily accept many new enrollees while remaining financially solvent.  

HOW IT’S WORKING: About 15 million people or 75% of people covered by the health care law are enrolled in Medicaid (Department of Health and Human Services), which has struggled to keep its promises to present-day recipients. 

  1. Only 70 percent of physicians accept new Medicaid patients, making it difficult for patients to make timely doctor’s appointments.  (Health Affairs)
  2. For nearly 60 percent of physicians, Medicaid fees were less than two-thirds of those paid by the uninsured. Three-quarters of physicians receive lower fees for treating Medicaid patients than they do for treating the uninsured. (National Bureau of Economic Research)
  3. Increasing numbers of doctors refuse to deal with new Medicaid patients because each patient visit is reimbursed less than what it costs the doctor’s office to see them. (New York Times)
  4. Surgical patients on Medicaid are 13 percent more likely to die than even patients with no insurance at all.  They are 97 percent more likely to die than those with private insurance. (Univ. of Virginia Study)
  5. The poor standard of care for Medicaid patients has resulted in severe harm and even in some cases, death. (Washington Post Story)
  6. Previous Medicaid expansions have not reduced the percentage of the population that is uninsured. (Foundation for Government Accountability)
  7. A 2013 study showed Medicaid coverage had no measurable impact in improving the health of enrollees vs being uninsured. (New England Journal of Medicine)

HOW IT’S WORKING: Medicaid is already plagued with budgetary problems.

  1. Total nationwide Medicaid spending increases for each state that accepts Medicaid expansion. (
  2. In the states where Medicaid has been expanded, the actual enrollment in Medicaid has far exceeded the predictions for how many would sign up. (Foundation for Government Accountability)
  3. Medicaid has been classified as a high-error risk program. Each year, it sends out billions of dollars in overpayments due to eligibility review errors or lack of information. (Government Accountability Office)
  4. Projections of Medicaid spending are unreliable: Arizona’s past Medicaid expansion has cost the state four times more than originally projected. (Foundation for Government Accountability)
  5. The Medicaid expansion is set to cost the federal government more than $630 billion over 10 years.  (Congressional Budget Office)
  6. To make up for the money lost providing care to Medicaid patients, health providers shift costs to people who are privately insured.  The average family already pays $1800 more per year in health costs to help providers recoup the costs of underfunded government insurance programs. (Milliman study) This cost-shifting is likely to increase as more and more people become dependent on Medicaid.
  7. Medicaid enrollment has soared past 70 million people since states began expanding the program in 2014. (Kaiser) Not all were from the expansion; others were from the so-called “woodwork effect,” where people who were previously eligible enrolled to avoid the individual mandate penalty. (
  8. Ohio’s Medicaid expansion has already cost $8.4 billion, exceeding estimates by $3.5 billion. Gov. Kasich projected the program would cost $13 billion in its first seven years, but it’s on track to more than double that. Ohio’s total Medicaid spending skyrocketed by $2 billion in 2016 and by $7.8 billion–a 44% increase–from 2011-16. (Forbes)
  9. Those in the states that did not expand Medicaid will save over $392 Billion by 2022, which is more than $3,181 per household. (Foundation for Government Accountability


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