North Carolina legislators have a crucial decision to make—whether to support or oppose the biggest ever expansion of government and the welfare state. Obamacare’s Medicaid expansion is fundamentally a question of government’s size and proper role. This should be an easy decision for legislators who value limited government and a safety net reserved for those who truly need public assistance. The fact that Medicaid expansion results in disappointing health outcomes should make opposition to Medicaid expansion an even easier call.
There’s much that North Carolina legislators can learn from other states that adopted Obamacare’s Medicaid expansion to cover childless, non-disabled, working-age adults. While the expansion was supposed to be limited to people with lower income, states that expanded—enabled by virtually nonexistent federal oversight—permitted millions of people with income well above the eligibility thresholds to enroll. Medicaid expansion states experienced much greater enrollment and spending than they projected. Obamacare has caused the national amount of improper Medicaid spending to soar to a staggering $100 billion a year, per a recent federal government report. There is nothing conservative about such a massive increase in wasteful government spending.