Money at stake in Medicaid decision

Annie Lowrey has a state-by-state look at the amount of money at stake as states decide whether to go forward with the Medicaid expansion in the ACA. In the case of North Carolina, if we take the full expansion that would mean around $1 Billion of new state spending from 2014-19, which would leverage around $20 Billion of additional federal spending into the state over the same period (or 4.7% of state GDP). Update: The 4.7% of GDP calculation has a numerator of spending from 2014-19 with a denominator of 2011 state GDP. It is consistently calculated across states so gives a relative sense of how much states have to lose, but the amount that would come from Medicaid expansion is not worth 4.7% of estimated state GDP for each year as was implied by the way I originally wrote the post.

Around 600,000 North Carolinians would be insured via this expansion who otherwise will not be. I have been working on some back of the envelope calculations of this sort (cost and expansion), but also understand that others including the state Division of Medical Assistance (Medicaid) are working on precise estimates. We need the final estimates, but this gives you a sense of the debate.

Halve the number of uninsured persons in North Carolina by the state paying 5 cents on the dollar.

If expanding health insurance coverage is understood to be a public policy goal, there will never be a better deal for North Carolina than this. If others have alternative routes to expanding coverage that are anywhere near this magnitude for anywhere near this cost to the State, I would love to hear them and I will blog about them.