Patrick Ishmael

Instead of getting a handle on the cost of care and working to maximize access to medical professionals, the Affordable Care Act instead prioritized "coverage"—a strategy that not only threw millions of Americans out of their private health insurance plans, but also put millions more into broken welfare programs. Over the past few years in particular, analysts at the Show-Me Institute have written a great deal about the importance of reforming Missouri's Medicaid system to ensure that our neediest can find the care they need. Simply expanding "coverage" and dumping enrollees into already-failing government programs would not only burden taxpayers, but also would imperil care for thousands of Missouri's most vulnerable citizens.

Indeed, those risks are now playing out in Ohio.

Most of the Ohioans who entered Medicaid under the expansion are working-age adults without children or disabilities. Before Obamacare, Medicaid was restricted to children, the elderly, the disabled, pregnant women, and impoverished families.

Pitching Obamacare expansion to the Ohio General Assembly in 2013, the Kasich administration estimated 447,000 would enroll by fiscal year 2020. Actual enrollment exceeded 620,000 by the time fiscal year 2015 ended in June.

Kasich implemented Obamacare expansion after vetoing a legislative ban on the policy, despite publication of a National Bureau of Economic Research study finding Tennessee’s employment increased when the state removed working-age adults from Medicaid.

Money spent on these able-bodied beneficiaries is money that cannot be spent on unequivocally vulnerable populations. And perversely, as Ohio has expanded its Medicaid program to those not in poverty, it appears the state is also planning cuts to services for some of Ohio's neediest, including the disabled

Missouri's neediest beneficiaries deserve better than that, and Missouri taxpayers should be able to rest assured not only that their tax dollars are going toward help for those who need it the most, but that failed government policies—particularly those we are seeing fail in real time across the country—aren't brought home to the Show-Me State. We should reform Medicaid for Missouri's neediest. We should not expand it under Obamacare.

About the Author

Patrick Ishmael
Director of Government Accountability

Patrick Ishmael is the director of government accountability at the Show-Me Institute.