The Leaflet – Will Your State Benefit From Medicaid Expansion?

Published March 28, 2013

Does your state benefit from President Barack Obama’s expansion of the Medicaid program, or does the expansion just put you on the hook for millions or even billions in new taxes to pay for money presented as “free”?

Currently 18 states have decided not to move forward with expanding Medicaid or are leaning in that direction, saying Medicaid is a failed entitlement program that should not be expanded but reformed. These states go on to argue expansion would lead to higher taxes in future years would be nearly impossible to roll back once enacted.

The Heartland Institute has built a useful shareable map based on numbers from the left-leaning Urban Institute modeled forward by the right-leaning Heritage Foundation, presenting the amounts each state is expected to have to come up with under the Medicaid expansion over the next ten years. States in green are on the hook for more in taxes, states in blue aren’t. Mouse over the state to see the amounts, and click to see a graph of the costs going forward.

With so many questions regarding the options surrounding Medicaid expansion, Heartland will address that issue during its monthly Emerging Issues Conference Call on Wednesday, April 3 at 1:00 p.m. EST. Heartland Research Fellow Benjamin Domenech will give his view of Medicaid expansion and answer some of your questions. To RSVP, please email Robin Knox at [email protected] to make sure that you receive all the information for the call.

This week’s edition of The Leaflet features research and commentary addressing the Medicaid expansion, hydraulic fracturing in Florida, protecting student data, Illinois pension reform, yet another proposed beachhouse bailout, and the CIA snooping in your bank account.
John Nothdurft
Director of Government Relations
The Heartland Institute


What Strategy on Medicaid Reform?
Health Care

James Capretta discusses the Medicaid strategy states ought to use. He warns against accepting the Arkansas deal without knowing what’s in it:

“The GOP governors engaged in these direct negotiations with the White House are playing a loser’s game, and throwing away a historic opportunity to secure fundamental and lasting reform of the Medicaid program. Even if individual states are able to secure concessions from HHS and the White House, the “deals” they strike will be in the form of temporary and inconsequential “waivers” (the terms of which will always be subject to administration amendment and revision, too). What’s worse, these deals are no way to run a national program. Why should one state receive more favorable treatment than others? And why should the administration be allowed to “buy off” states with federal taxpayer funds in the first place?”

“Instead, GOP governors should withdraw from this White House game of “let’s make a deal” and instead decide, as a group, what kind of Medicaid reform to demand in return for considering broader insurance coverage. Importantly, the reforms they seek should be in the form of legislative revisions of Medicaid, not temporary “waivers.” By pursuing a legislative approach, the GOP governors could join forces with House speaker John Boehner and Energy and Commerce Committee chairman Fred Upton, who have made serious Medicaid reform one of their top priorities this year.”

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Research & Commentary: Hydraulic Fracturing in Florida


Heartland Policy Analyst Taylor Smith examines Florida’s prospects for allowing hydraulic fracturing. Florida produces both oil and natural gas, particularly in the southwest region and Panhandle. Opponents claim hydraulic fracturing would threaten public health through potential contamination of underground water tables used for drinking water supplies.

Taylor writes, “Although hydraulic fracturing has never been utilized in Florida, data from the Interstate Oil & Gas Compact Commission, a multistate government agency, found more than 8,000 wells have been fracked in Alabama, contiguous to the Panhandle, since the 1940s, and no harm to groundwater has ever been recorded.”

Op-Ed: States Should Move Swiftly to Protect Student Data


States and schools are signing over private data (including names, Social Security numbers, hobbies, addresses, test scores, attendance, career goals, and attitudes about school) from millions of students to companies and researchers who hope to glean secrets of the human mind. Research Fellow Joy Pullmann says it’s up to states to block this intrusion on student data and explains how.

Joy writes, “Any researcher or organization wanting to plumb data to potentially help kids learn more, faster, can do so without trampling individual rights.”

Research & Commentary: Illinois Pension Reform

Budget & Tax

The state employee pension system in Illinois is broke, both financially and structurally. Without an overhaul of the current, unsustainable system, Illinois taxpayers will continue to suffer substantially higher taxes to bail out the state for its imprudent policies. If state workers and union representatives cannot accept sensible changes to the pension system, more state workers will be laid off, taxes will increase, and the state’s economy will decline even further.

A bill currently being considered would take bold steps toward creating a pension fund that allows the state to ensure its obligations to workers while keeping costs down. Based on a model from the Illinois Policy Institute, House Bill 3303, sponsored by Reps. Tom Morrison (R-Palatine) and Jeanne Ives (R-Wheaton), would cut the state’s unfunded pension debt in half, move new hires into a 401(k)-style defined contribution plan, and protect the benefits that government workers already have earned.

In this Research & Commentary, Senior Policy Analyst Matthew Glans argues the proposal is a solid improvement for the Illinois pension system, making substantive reforms that cut current costs and manage future pension liabilities while protecting existing benefits for public employees.

‘Beachhouse Bailout’ Bill Reintroduced in Congress
Finance, Real Estate, and Insurance

In this article from The Heartlander digital magazine, Matthew Glans examines legislation recently reintroduced by Rep. Albio Sires (D-NJ) that would establish a federal bailout system for financially stressed state-run property insurance programs such as the Florida Hurricane Catastrophe Fund. The Florida Cat Fund currently has around $17 billion in liabilities and likely could not fully pay claims if a large hurricane were to strike the state.

The bill, referred to as a “beachhouse bailout” by many of its critics, has appeared in several guises over the years. The bill’s opponents call it a beachhouse bailout because expensive beachhouses are usually the first damaged where hurricanes land.

“As surely as there is a hurricane season, there apparently is also a season to try to shift insurance risks away from people who own property in hurricane-prone areas to property insurance buyers around the country.”

CIA, Other Spy Agencies Could Be Snooping on You and Your Bank Accounts

The Central Intelligence Agency, National Security Agency, and other United States government spy agencies could receive full access to huge amounts of financial data on Americans and others who do banking in the United States, according to a report from the Reuters news agency.
Steve Stanek, editor of Budget & Tax News, examines in this Heartlander article a recent report from Reuters that describes a developing plan by the Obama administration to allow government spy agencies to obtain, track, and analyze the financial records of anyone with a bank account in the United States. The CIA and other spy agencies have never been allowed to operate inside the nation’s borders except in rare case-by-case instances.

“It’s troubling when information is collected for one purpose under one set of requirements and is redirected for another use,” said Sharon Bradford Franklin, senior counsel for the Rule of Law Program at the Constitution Project, a nonprofit watchdog group.

“It certainly should raise concerns over whether there are adequate safeguards to protect information and the thresholds” for collection of information on individuals. “We don’t know if we have these safeguards.”