Medicaid Expansion: Dichotomous Philosophy Threatens the Economy and Health of Millions

Medicaid is a federally funded program that insures disabled, elderly and low-income Americans. While all 50 states have yet to opt-in to its expansion per the Affordable Care Act (ACA), which would add 21 million people to its rolls, or half of the nation’s uninsured, many states chose to opt in following the June 2012 U.S. Supreme Court decision which deemed the Patient Protection and Accountable Care Act (PPACA) constitutional (AAFP)(Mears)
Despite the ruling of the Supreme Court, the decision to accept Medicaid remains a divisive and heavily debated issue in many states. Indeed partisan bickering, already strained budgets and questions of uncertain monetary futures all weigh heavily upon those relegated to make the final decision of acceptance or refusal. There is also a question as to whether refusal to accept is ultimately meritorious, as acceptance necessarily requires states to agree to some future percentage of the bill while refusal renders them ineligible for millions in federal funding every year. Thus, in a way, the ACA, perhaps much like many governmental policies, could well be considered a gamble either way. Accept it now and don’t miss out on federal funding or decline it, miss out on the funding but don’t put your state on the hook for unknown quantities of money that have to come from somewhere.
The option of acceptance or refusal is indeed a very loaded choice; one that comes with strings attached as Federal expansion incentives have created a best-case scenario by enticing states with the federal government footing 100% of new recipient cost for the for the first three years (Barker). Yet, as previously mentioned, the consequences of acceptance or rejection are exceedingly uncertain as future responsibility lays increasingly with state budgets to