Session Notes: Obamacare’s Medicaid Expansion Fails Again

With the 2016 legislative session behind them, Missouri's legislature has once again rejected Obamacare's Medicaid expansion. Had it passed, the program would have added thousands of able-bodied, childless adults living above the poverty line to Missouri's welfare rolls, with the state picking up an increasing share of the cost in the years ahead. 

The legislature was right to reject the Medicaid expansion for a number of reasons—among them, the program's patient access and health outcome problems and its soaring cost to taxpayers. But one of the most important arguments against expanding welfare to the unimpoverished was captured by Ronald Reagan in testimony to Congress nearly 50 years ago. Reagan's admonition that "[w]e should measure welfare's success by how many people leave welfare, not by how many more are added" is probably the best-recognized line from that speech. But I'd like to quote another sentence that is at least as important:

It doesn't seem right to reduce a man's take-home pay with taxes and then send him a government dole which robs him of the feeling of accomplishment and dignity which comes from providing for his family by his own efforts.

It's a bad idea to create a new class of welfare recipients and graft them into a broken program like Medicaid, but it is an especially bad idea to substantively change the standard for who is supposed to be receiving welfare to begin with. Medicaid is broken, but even if it weren't, government shouldn't be freshly yoking millions of able-bodied Americans to the welfare state. 

Reform-minded free marketeers should look for ways to empower workers and widen their opportunities. Unfortunately, in too many ways, the "Affordable Care Act" does precisely the opposite. Congratulations to the legislature for holding firm against Obamacare.