The Associated Press noted Tuesday that one part of Obamacare is going extremely well: new enrollments in an expanded Medicaid program. According to estimates, Medicaid has added over 400,000 new patients in ten states–roughly two million across the country, by extrapolation. That is about twenty times more successful than the Obamacare exchanges, which have only enrolled about 100,000 nationwide.
Critics of Obamacare have cited the fact that almost all of the enrollees thus far have been into Medicaid as a sign of the policy’s failure. On the contrary: that is a sign of the policy’s success.
Yes, the middle-class portion of Obamacare is a complete farce, as millions continue to lose their individual health policies, and millions more will lose their employer-based policies next year. And, yes, even more low-income families might be signing up for Medicaid if the websites were working well enough to tell them they are eligible for it.
But in terms of the Democrats’ long-term goal of increasing the proportion of Americans who depend on government for their health care, the fact that so many are pouring into state-based, federally-assisted Medicaid programs is a landmark achievement that will not easily be rolled back.
And that is a feature of the program, not just a website bug.
Medicaid is, in many ways, the most troubled of America’s entitlement programs. It puts immense strain on many state budgets and is rife with waste and fraud. In Illinois, an ongoing audit revealed that one in four Medicaid recipients is actually ineligible for the program. Hundreds of thousands are being booted from Medicaid in Illinois as a result–but more will be added (and some could be added back) through Obamacare.
That is why it makes no sense for Republican governors like Chris Christie, who accepted Obamacare’s expanded Medicaid funds, to claim that they actually oppose Obamacare simply because they declined to set up state-based health insurance exchanges. They have bought into what is, thus far, the biggest part of the program and the part that will likely do the most long-term damage to both state and federal budgets.
In the medium term, Republican governors who took the Obamacare money will face off against House Republicans in Washington who want to trim entitlement spending.
The division between “establishment” Republicans and the Tea Party may pale next to the differences between GOP governors dependent on federal spending and a Congress elected on promises to cut it.
A divided opposition: another Obamacare “success.”