Notes from Brett: Medicaid expansion a costly mistake

Contrary to some people's thought, this expansion is not free money. In a few short years, the state's share will grow to 10 percent of the total cost for these newly eligible beneficiaries. Other provisions in the health care law will already c

Expanding Medicaid eligibility in Kentucky is not only unsustainable; it is also irresponsible.  By shifting the focus away from Medicaid’s core mission of children, pregnant women, the disabled and seniors, those vulnerable populations will be forced to fight for precious resources in future years.

Contrary to some people’s thought, this expansion is not free money.  In a few short years, the state’s share will grow to 10 percent of the total cost for these newly eligible beneficiaries.  Other provisions in the health care law will already cause Medicaid rolls to grow, and this expansion to childless adults further adds to the burdens on Medicaid. The focus needs to be on reforming these programs for the future.

There also appears to be a disconnect about the true cost to Kentucky families.  Although the state’s share may be minimal over the next few years, the expansion comes at a huge cost to the federal government, meaning taxpayers are still footing the bill.  Even the Kentucky budget director admitted to this cost-shifting, saying, “With the federal government covering the full cost of expansion for the first three years, combined with the ability to shift some of our current cost burden to the federal government, expansion will be a very large net positive to our taxpayers' bottom line.”

The impact on the state budget will still be substantial.  Kentucky has curbed spending, reformed pensions, and reduced funds for post-secondary education, yet Medicaid spending has nearly doubled in the last decade.  More money spent on Medicaid means less money for k-12 education, colleges, economic development, and other programs.

At the federal level, Medicaid is already an unsustainable piece of a massive budget that is in dire need of reform.  As Congress works to address the federal budget problems and tackle entitlement reform, Medicaid reform continues to be discussed.  Kentucky’s expansion of Medicaid doubles down on an already-broken program that is in need of imminent reform.

Next week, the House of Representatives will again vote to repeal Obamacare.  I have voted more than 30 times to repeal, reform, and/or defund Obamacare and one of the key reasons was this unsustainable Medicaid expansion.

Kentucky was ranked the 44th healthiest state in the nation by the United Health Foundation.  We need to improve the health of our citizens, but we cannot achieve that by ballooning programs to the point they burst.  We must reform Medicaid, along with Medicare and Social Security, to ensure they are still available for future generations.


Congressman Brett Guthrie is a member of the Health subcommittee on the House Energy and Commerce Committee, which has jurisdiction over Medicaid.