Apologies for the prolonged blogging hiatus. I’m not dead yet, just snowed under—I’ll resume my regular blogging at the nearest occasion. Herewith a forthcoming law review piece on the “Medicaid ruling” of NFIB v. Sebelius. The gist of it: NFIB didn’t really do very much about the horrendous economic incentives that drive the program.
“Not very much” doesn’t mean “nothing”: on the margin, the ruling may have increased some states’ willingness to forego the “opportunity” to expand the program even further; and in the short term it is an opportunity. To illustrate: in my home state of Virginia, newly elected Governor McAuliffe promised to finance big road-building investments—how? By participating in the Obamacare Medicaid expansion.
It’s the long-term costs that are ruinous. Not that that would concern a single-term governor. The question is, how big is the margin? Not big enough for Arizona, which has decided to join. This study strongly suggests that the consequences will be very bad. It’s a sad story. Sadder still is the larger story: Medicaid is ruinous with or without Obamacare.