Medicaid expansion states shouldn't sweat the cost, according to a health policy analyst.
"The strong balance of objective evidence indicates that actual costs to states ... are negligible or minor, and that states across the political spectrum do not regret their decisions to expand Medicaid," wrote Mark Hall, a nonresident senior fellow at the Brookings Institute's Center for Health Policy.
Funding and monetary issues have long been a major reason why 18 states still haven't expanded the program with critics contesting that expansions are too costly for state budgets. A report (PDF) issued by the Foundation for Government Accountability earlier this year called Medicaid expansion "a proven disaster."
But Hall countered that claims lamenting the high costs of expansion are overstated and inaccurate since established funding under the Affordable Care Act pays for 90% of the cost of covering people below 138% of the federal poverty line.
He also pointed to a Health Affairs study last year that used data from the National Association of State Budget Officers to show that by 2015, there was "no significant increases in spending from state funds as a result of the expansion." Although states were likely to incur some costs starting in 2015 after their funding requirement began.
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While not entirely free to states, based on experience to date, the costs of expansion are low compared to the economic and public health benefits, Hall added.
Early this week, former Centers for Medicare & Medicare Services Administrator Andy Slavitt argued that momentum for Medicaid expansion is gaining traction and that the 18 states that have waited will soon follow suit. Current CMS Administrator Seema Verma also confirmed that the agency is required by law to review expansion applications regardless of the Trump administration's disapproval.
Despite opposition within some Republican-controlled state legislatures and governors' mansions, expansion has been generally popular among state-level republican heads who have expanded the program. Republican governors in at least five states have expressed their continued support for expansion, including Ohio, Nevada, Michigan, Arizona and Arkansas, the Brookings analysis noted.