While some in Congress are spending their days figuring out how to bailout the Obamacare federal high risk pools by shuffling money between accounts, there is an ongoing battle over the implementation of the Obamacare Medicaid Expansion in which conservatives can actually score some real wins.
Governors and state legislatures are making decisions right now as to whether they're going to accept massive amounts of federal spending, as well as increase spending on their own, for the Obamacare Medicaid Expansion. States led by Democrats have unsurprisingly fallen in line with the expansion. Several Republican governors, most notably Governors John Kasich (OH) and Rick Scott (FL), have been lured in by the dubious promise of free federal money.
Conservatives can battle this implementation of Obamacare on two fronts: 1) showing the federal government cannot be relied upon to provide the funding for states to cover this massive expansion of government health care; and 2) explaining that Medicaid does not work.
Rep. Matt Salmon (R-AZ) is already doing good work on convincing the states the feds cannot be trusted to keep their funding promise. He has introduced a bill to repeal the incentive - enhanced match in wonk-speak - for states to pull more people into a failing Medicaid program. Heritage Action has written about the benefits of the bill here. Rep. Salmon recognizes we cannot even afford the entitlements we have so, the federal government should not encourage their expansion.
Not only can we not afford an expansion, Medicaid is not working for its current beneficiaries. The result of a study of a 2008 expansion of the Oregon Medicaid program shows that Medicaid removes a financial burden for the poor, but does not produce better health care outcomes for them than if they had no insurance at all. The Oregon study is the most recent in a long series of studies that show the problems with the care Medicaid beneficiaries receive. This seems to beg the question why are we expanding a health care program that doesn't improve its beneficiaries' health? Shouldn't we try to find a better way to ensure the poor have access to quality health care?
2013 presents the last opportunity for conservatives to stop the implementation of Obamacare before its unaffordable entitlements come online next year. The Medicaid expansion is one of the best opportunities to limit the damage.