Don’t Believe That Conservative Republican Governors Are About as Ignorant of Governmental Finance as One Can Be – They Want to Turn Down Huge Federal Aid

Denying Citizens Health Care is Not Only Bad Politics, Under ACA It is Bad Economics

Conservatives are schizophrenic (yes we do mean they are crazy) on the Supreme Court ruling on the health care act.  They are furious the Court found a way to declare the act valid, but Republicans take solace from the fact that the Court said that states could opt out of expanded Medicaid coverage if they so wish, and not be penalized for their existing Medicaid benefit.  Republican Governors have leapt to the microphones to declare that they will do just that.

The immediate impact will be to deny health care coverage to millions who would have been covered under the expanded Medicaid eligibility rules.  But of course Conservatives really don’t care about that.  In fact they see nothing wrong with state office holders like themselves getting extremely good health care insurance from the state government and then denying any coverage to low income people.

But these same Conservatives pride themselves on their business like approach to state government.  So one wonders how they will justify walking away from huge federal spending that requires only a tiny amount of extra spending on their part.  The Economix blog in the New York Times has the data.

Using estimates from the highly reliable Kaiser Foundation, Economix determined for each state how much dollars and what percent of state GDP the state would spend and the Feds would spend over a six year period.  Let’s take the great state of Texas, whose Republicans lead by their Governor are just incensed about the program.  Over the 2014-19 year period Texas would have to pay an amount equal to .20% of its 2011 state GDP.  This is the equivalent of a family whose annual income is $50,000 a year having to come up with $100.00 in total over six years.  That’s right, less than $20.00 a year for an average Texas family. 

But what will Texas get in return?  Over that same period the Federal Government will give Texas over $52 billion for health care, or 4.4% of its 2011 GDP.  Texas spends $2.6 billion of its state money over six years, get an additional $52 billion from the Federal government.  And that $52 billion goes directly to the health care system, which lowers the cost of health care for everyone. 

Here is the full table, look up what your state would spend and what they would get back.  Then ask yourself, how dumb do Republicans in Texas and other states have to be to turn this down?  If your answer is ‘they don’t have measurements that high’ you have chosen the correct answer.

"I created a chart to show how much a state would have to spend in dollar terms and as a percentage of its 2011 economic output to expand coverage between 2014 and 2019. (The cost estimates come from the indispensableKaiser Family Foundation, and the state output estimates come from theBureau of Economic Analysis.) I also added in how much the federal government would spend in a state if it chose to expand coverage, again in dollar terms and as a percentage of the given state’s economic output.

A few states would actually save money — meaning their new spending would be negative. Those states already have relatively broad Medicaid eligibility, and would have to spend less as the federal financing in the Affordable Care Act kicked in. (For more on how that works, see this Kaiser study.)

You can check your state out in the table below, created with the help of the graphics designer Alicia Parlapiano."

	State spending, 2014-19, in millions	State spending as percentage of 2011 G.D.P.	Federal spending, 2014-19, in millions	Federal spending as percentage of 2011 G.D.P.
Vermont	($26)	-0.10%	$112	0.43%
Massachusetts	($1,274)	-0.33%	$2,137	0.55%
Delaware	$3	0.00%	$387	0.59%
New York	$50	0.00%	$8,049	0.70%
Arizona	$56	0.02%	$2,091	0.81%
District of Columbia	$42	0.04%	$902	0.84%
North Dakota	$32	0.08%	$595	1.48%
Wisconsin	$205	0.08%	$4,252	1.67%
South Dakota	$32	0.08%	$717	1.79%
Wyoming	$32	0.09%	$683	1.82%
New Jersey	$533	0.11%	$9,030	1.85%
Iowa	$147	0.10%	$2,800	1.88%
New Hampshire	$63	0.10%	$1,204	1.89%
Connecticut	$263	0.11%	$4,686	2.04%
Virginia	$498	0.12%	$9,629	2.24%
California	$2,982	0.15%	$44,694	2.28%
Washington	$380	0.11%	$8,271	2.33%
Nebraska	$106	0.11%	$2,345	2.49%
Colorado	$286	0.12%	$5,917	2.53%
Nevada	$188	0.14%	$3,445	2.64%
Kansas	$166	0.13%	$3,477	2.66%
Florida	$1,233	0.16%	$20,050	2.66%
Minnesota	$421	0.15%	$7,836	2.78%
Illinois	$1,202	0.18%	$19,259	2.87%
Louisiana	$337	0.14%	$7,273	2.94%
Pennsylvania	$1,054	0.18%	$17,086	2.95%
Maryland	$533	0.18%	$9,112	3.03%
Indiana	$478	0.17%	$8,535	3.07%
Rhode Island	$70	0.14%	$1,559	3.11%
Utah	$174	0.14%	$4,129	3.32%
Missouri	$431	0.17%	$8,395	3.36%
Georgia	$714	0.17%	$14,551	3.47%
Ohio	$830	0.17%	$17,130	3.54%
Maine	($118)	-0.23%	$1,857	3.60%
Michigan	$686	0.18%	$14,252	3.70%
Alaska	$117	0.23%	$2,046	3.98%
Texas	$2,619	0.20%	$52,537	4.02%
Tennessee	$716	0.27%	$11,072	4.15%
Idaho	$101	0.17%	$2,402	4.15%
Hawaii	($28)	-0.04%	$2,999	4.48%
North Carolina	$1,029	0.23%	$20,712	4.71%
Oregon	$438	0.22%	$10,302	5.29%
West Virginia	$164	0.25%	$3,781	5.66%
New Mexico	$194	0.24%	$4,510	5.68%
Montana	$100	0.26%	$2,178	5.73%
Alabama	$470	0.27%	$10,305	5.95%
South Carolina	$470	0.28%	$10,919	6.59%
Kentucky	$515	0.31%	$11,878	7.21%
Oklahoma	$549	0.35%	$12,179	7.86%
Arkansas	$455	0.43%	$9,401	8.88%
Mississippi	$429	0.44%	$9,865	10.09%