Governor Jack Dalrymple's "No Cost" Obamacare Medicaid Expansion To Cost 182 Percent More Than Expected

Back during the 2013 legislative session North Dakota Governor Jack Dalrymple was defending his push to implement the Obamacare expansion of the Medicaid program. The law as passed by Congress made the expansion mandatory, but the Supreme Court struck down the provision in the law punishing states for not expanding the program essentially making it optional.

Some states decided not to expand the Medicaid program. North Dakota did. Because, according to Dalrymple, we didn’t want to lose out on that free federal money to pay for the expansion.

“In the end, it comes down to are you going to allow your people to have additional Medicaid money that comes at no cost to us, or aren’t you?” Dalrymple told Fargo Forum reporter Mike Nowatzki. “We’re thinking, yes, we should.”

“There really is no good reason to stand in the way of 20,000 North Dakotans having the opportunity to get health insurance coverage at no cost to themselves,” he continued. “I think that really is the overriding consideration.”

Two and a half years later, it turns out the the cost of the “no cost” program Dalrymple was touting is going to be 182 percent more than expected.

BISMARCK, N.D. (AP) – North Dakota’s costs for expanding Medicaid under the Affordable Care Act are higher than had been projected.

The Department of Human Services has revised its cost estimates from $2.9 million to $8.2 million for the 2017 fiscal year. The agency says actual health care costs are higher than forecast when the state opted to expand the health program for the poor in 2013.

The feds are picking up the tab for this expansion through 2016, at which point the states begin to take over. By 2020 the plan is for North Dakota to be paying for 10 percent of this “no cost” program.

Because of course there was always a cost to this. We, as federal taxpayers, have been picking up the tab the whole time. And starting in 2017 we’ll be picking up the cost as state taxpayers too.

Probably good, if cynical, politics for Dalrymple though. In the short term he doesn’t have to fight a political battle over denying the expansion, and in the long term he’s not going to be in office when the bulk of these costs get dumped on the state.

Win-win for him, I guess.