Don’t get me wrong – I have no problem with this per se. I want the poor to have health care coverage. But let’s be clear, it will cost a lot more money than the Medicaid expansion would. Per Avik Roy, it will cost the federal government 50% more now, and both the feds and the state more in the future. I agree with Matt Yglesias that providers will love this – cause they’ll get more money. That’s why this costs more.
I guess some people assume progressives love Medicaid just because it’s government run. I support the expansion not because it’s un-private, but because it’s a cost-effective way to expand insurance coverage to the poor. Since so many conservatives think we can’t afford the cost of the Medicaid expansion, it seems odd to me that they’d be willing to spend more money to give them private insurance. I assumed that when they said we didn’t have the money for Obamacare, they meant we needed to spend less. I assumed that fiscal conservatives were worried about health care spending.
I imagine we’ll see another revision of history. I expect some will write that if only Obamacare had allowed more of the poor to get private insurance, if only it had allowed for that spending, than surely it would have had more support. Is that what opponents of Obamacare wanted? For it to be more expensive?
UPDATE: Sarah Kliff pointed out Arkansas didn’t technically get a “waiver”. She’s right.