Dalrymple's Medicaid Flip-Flop Is Puzzling

Nina Owcharenko from the Heritage Foundation finds support for the Obamacare Medicaid expansion among Republican governors, such as North Dakota’s Jack Dalrymple, puzzling:

Governor John Kasich now joins the list of governors that are looking to expand their Medicaid programs. In some instances, the logic of such a decision makes sense. Democratic governors have traditionally supported expanding the role of Medicaid. But the decision by Republican governors, such as Governor Jan Brewer (Ariz.), Governor Jack Dalrymple (N.D.), Governor Susana Martinez (N.M.), Governor Brian Sandoval (R., Nev.), and now Governor John Kasich (R., Ohio), is puzzling.

Like most government programs, Medicaid promises more than it delivers. While it consumes an ever increasing portion of state budgets — crowding out other state priorities, such as education and transportation — its track record for delivering quality health care to those in need falls short. Endorsing the expansion ignores these underlying problems and in some instances seems to make them worse.

Of these five Republican governors, four joined the lawsuit against the Obama administration regarding the coercive nature of the Medicaid expansion. It is troubling that now that the Medicaid expansion has been deemed voluntary not mandatory by the Supreme Court, these governors are perfectly happy to have the federal government coerce them into the expansion with the enticement of new federal dollars.

Second, many of these governors argue that the Medicaid expansion is actually good fiscal policy. These governors may be looking at a short-term bump in new federal dollars, but the longer view shows that over time this new revenue disappears and the cost of expansion continues to rise.

Noting that Medicaid enrollment is expected to explode to 1 in 4 Americans by 2017, Owcharenko is wondering why any governor would be in a hurry to expand the program. “In states that are trying to jumpstart their economy, it seems governors should be working to reduce dependence on the welfare state, not add millions more to it,” she writes.

Indeed, Dalrymple was opposed to this Medicaid expansion until the legislative session at which point he slipped it into his executive budget suggesting the expansion would come at “no cost” to North Dakota taxpayers.

As if North Dakota taxpayers weren’t also federal tax payers. By the way, according to estimates, this expansion would increase Medicaid enrollment in North Dakota by 46%.

The federal government can’t afford these dollars and, what’s more, North Dakota ought not be obligating itself to an expanded program going forward. The Supreme Court made this Medicaid expansion optional. North Dakota and other states should opt out of a bad deal.