“This budget reflects the same skewed priorities… Americans rejected in November.”

“It will take more than accounting gimmicks to achieve real deficit reduction.”

Washington, D.C. – Senate Majority Leader Harry Reid spoke on the Senate floor today regarding Representative Paul Ryan’s budget proposal. Below are his remarks as prepared for delivery:

Early this year, with November’s election losses fresh in their minds, top Republicans promised a kinder, gentler Republican Party – a Republican Party that cared about “every American…achieving their dreams.” Republicans bandied about words like fairness and opportunity. They made overtures toward women and Hispanics. They promised cooperation and an end to brinksmanship. House Majority Leader Eric Cantor even spoke of, “an agenda based on a shared vision of creating the conditions for health, happiness and prosperity for more Americans and their families.” The rebranding was under way.

Then a few weeks passed. And the Republican emphasis on fairness and equity passed along with them.

Today House Budget Committee Chairman Paul Ryan will unveil an extreme budget that is anything but balanced. This budget reflects the same skewed priorities the Republican Party has championed for years – the same skewed priorities Americans rejected in November. The Ryan Republican budget will call for more tax breaks for the wealthy, an end to Medicare as we know it and draconian cuts to education and other programs that help America’s economy grow and prosper.

As Yogi Berra famously said, “It’s déjà vu all over again.” We’ve seen this show before. The Ryan Republican budget will shower more tax breaks on millionaires and continue to tilt the playing field to the advantage of big corporate interests, while raising taxes for the middle class. And, like last year, the plan refuses to close a single tax loophole in order to reduce the deficit.

Meanwhile it guts investments in education, health care, public safety, scientific research and job-creating clean energy technology. The Ryan Republican budget would end the Medicare guarantee and force seniors into a voucher program. It would ax preventive health care such as cancer screenings and charge seniors more for prescriptions. And it would further reduce funding for food inspectors, police officers and first responders.

And as if protecting wealthy special interests while shifting the burden to seniors and the middle class wasn’t bad enough, the Republican budget also devastates the economy, costing jobs and slowing growth. Not only is this the wrong approach, it’s the same old approach.

And to make matters worse, the Paul Ryan Budget 3.0 uses the same fuzzy math as his previous two budgets. It relies on accounting that is creative at best and fraudulent at worst to inflate its claims of deficit reduction.

Democrats believe it is critical that we stabilize the deficit. But it will take more than accounting gimmicks to achieve real deficit reduction. And at a time when corporations are making record profits, the stock market is soaring and wealthy Americans’ income continues to rise, that deficit reduction shouldn’t be come at the expense of middle-class families, senior citizens and the poor.

Americans have demanded a fair approach to deficit reduction that makes sensible cuts, but asks profitable corporations and the wealthiest among us to share the burden. Democrats have been listening. That’s why this week Budget Committee Chairman Patty Murray will introduce a budget that reflects those balanced principles. The Democratic plan will cut wasteful spending and reduce the deficit, close tax loopholes that benefit the rich and invest in what the economy needs to grow. It will encourage a strong middle class.

Congressman Ryan and his Republican colleagues in Congress have taken a different approach – an approach that makes it plain they missed the message of the November elections. Their budget will once again put moneyed special interests ahead of middle-class families. And no amount of rebranding will hide that.

Fundamentally Skewed Priorities in Republican Budget Would Hand More Tax Breaks to Wealthy at Expense of Middle-Class Families

Washington, D.C. – Nevada Senator Harry Reid spoke on the Senate floor today regarding Republican attempts to go back on an August budget agreement in order to protect multi-millionaires and corporate defense contractors at the expense of ordinary Americans. Below are his remarks as prepared for delivery:

Yesterday Republicans continued to filibuster Democrats’ plan to protect 7 million students from skyrocketing interest rates on federal student loans.

What’s worse, they seem proud of it. Not a single Republican voted to allow the debate on this bill to go forward.

But this fight is not over. Democrats have not given up efforts to keep college affordable for almost 30,000 Nevadans and more than 7 million students nationwide.

I hope Republicans will come to their senses, and work with us toward a compromise.

As Democrats work to create jobs and make college affordable, our colleagues on the other side of the aisle are operating under a different set of priorities.

In the House, Republican efforts are underway to undo a hard-fought August agreement to cut more than 2 trillion from the deficit over the next decade.

But the Republican budget and their so-called reconciliation bill don’t just renege on that bipartisan, bicameral agreement to reduce spending.

They reflect fundamentally skewed priorities. They hand out even more tax breaks to multi-millionaires and shield corporate defense contractors, all at the expense of hard-working, middle-class families, the elderly and those in greatest need.

They would slash investments that strengthen our economy and shred the social safety net.

President Dwight Eisenhower once said: “Every gun that is made, every warship launched, every rocket fired, signifies in the final sense a theft from those who hunger and are not fed, those who are cold and are not clothed.”

In a balanced world – one where a strong national defense and a strong social safety net are both valuable pillars of a successful society – that need not necessarily be true.

But the Republican plan would enshrine into law a set of truly unbalanced priorities – and ensure the kind of terrible math Eisenhower envisioned.

Unlike defense contractors and billionaires, ordinary Americans don’t have high-priced lobbyists to protect them. That’s our job.

But Republicans are going after those who can’t fight back – hard-working Americans and struggling families.

Let’s review a bit of history. The sequester isn’t the first bipartisan agreement to reduce the deficit.

Over the years there have been many efforts to reach comprehensive, bipartisan solutions to our deficit.

There was the Fiscal Commission, Bowles-Simpson, the Gang of Six and the Supercommittee. They all failed.

Although President Obama was willing to make difficult concessions to achieve meaningful deficit reduction, Republicans and Speaker Boehner could never go against Grover Norquist.

This is a Grover Norquist Congress.

So we’re left with the threat of almost $500 billion in cuts to domestic programs and almost $500 billion in cuts to defense programs.

Democrats agree the sequester – which includes across the board cuts both to domestic spending and the defense budget – is far from the ideal way to solve our nation’s fiscal problems.

It’s a tough pill to swallow. But that was the point.

Those cuts were designed to be tough enough to force lawmakers to compromise.  They were designed to be tough enough to force the two sides to reach to a balanced deal.

But Republicans refused to be reasonable. They refused to raise even a penny of new revenue, or ask millionaires to contribute their fair share to help reduce our deficit and our debt.

I’d like to read a short excerpt from a piece by Thomas Mann and Norman Ornstein from the Washington Post.

They eloquently describe the GOP’s unwillingness to compromise here:

“We have been studying Washington politics and Congress for more than 40 years, and never have we seen them this dysfunctional. In our past writings, we have criticized both parties when we believed it was warranted. Today, however, we have no choice but to acknowledge that the core of the problem lies with the Republican Party.”

They went on to say:

“The GOP has become an insurgent outlier in American politics. It is ideologically extreme; scornful of compromise; unmoved by conventional understanding of facts, evidence and science; and dismissive of the legitimacy of its political opposition.”

Republicans insisted on balancing the budget on the backs of the middle class, seniors, students, single mothers and so many others who could least afford it.

And it is their intransigence – their refusal to compromise – that leaves us facing the threat of the sequester, and its difficult but balanced cuts.

Going back on the August budget agreement now in order to protect wealthy special interests is no solution.

Neither is refighting the battles of last year.

Democrats agree we must reduce our deficit and make hard choices.

But we believe in a balanced approach that shares the pain as well as the responsibility.

Is the sequester the best way to achieve that balance? Absolutely not.

But Republicans refuse to consider a more reasonable approach – one that asks every American to pay his fair share while making difficult choices to reduce spending.

And Democrats won’t agree to a one-sided solution that lets the super-wealthy off the hook while forcing the middle class, and those in greatest need, to bear all the hardship.

Democrats believe we can protect Americans’ access to health care, create jobs while investing in the future and protect the poor and elderly.

And we can do all that while reducing the deficit in a responsible, even-handed way.

But we can’t do it alone. It will take hard work and compromise.

And so far Republicans have been unwilling to make a serious effort to achieve that compromise.

Republicans have rejected our balanced approach. Their one-sided solution to across-the-board cuts would take from the many to give to the few.

So, here’s what their plan would do:

• Cut Medicaid benefits, increasing the number of uninsured children, parents, seniors and people with disabilities by 300,000. It would also put seniors in nursing homes at risk.
• Punish Americans who receive tax credits to purchase health insurance when their financial circumstances change – causing 350,000 Americans to forgo coverage.
• Weaken Wall Street reforms, protecting big banks at the expense of consumers.
• Once again target middle-class workers, including food inspectors, air traffic controllers and border patrol, drug enforcement and FBI agents.
• Cut funding for preventive health care programs that fight chronic illnesses – such as heart disease, cancer, stroke and diabetes – that cause 70 percent of deaths in America.
• Slash Block Grant funding that allows states to help 23 million children, seniors and disabled Americans live independently and out of poverty.

No segment of the population is immune from the pain of this Republican plan – except maybe millionaires, billionaires and wealthy corporations.

The Republican proposal cuts Meals on Wheels for seniors.

It reduces food assistance for 1.8 million needy people.

And it cuts off 280,000 kids from free school lunches at a time when one in five children lives in poverty.

That’s why the U.S. Conference of Catholic of Bishops said the Republican plan fails a “basic moral test.”

This budget sets very clear priorities. The problem is, they’re the wrong priorities.

President Franklin Roosevelt once said, “Human kindness has never weakened the stamina or softened the fiber of a free people. A nation does not have to be cruel to be tough.”

Republicans would do well to remember our nation is judged not only by the strength of its military, but also by the strength of its values.

As a Result, 30 Million Americans Could Get Kicked Off Medicaid – Forcing Seniors to Be Denied Critical, Life-Saving Care

New State-by-State Analysis of Impact of Extreme GOP Budget Found HERE

Washington, DC—The Democratic Policy and Communications Center (DPCC) today released new national and state-by-state reports (see below) revealing the devastating impact the Republican Medicare-ending budget would have on seniors, families, and nursing home residents.  The report shows that, on top of ending Medicare as we know it and increasing seniors’ out-of-pocket health care costs by nearly $6,000, the GOP budget would also cut $1.7 trillion in Medicaid benefits for seniors, families, and those in nursing homes, which could force as many as 30 million Americans off of the program.

The GOP budget cuts $550 billion in health care benefits specifically for seniors and the disabled, which could lead to them being denied access to life-saving care and shutting nursing homes down across the country.  With state governments across the country already cash-strapped, the reduced federal support and increased burdens included in the GOP proposal would require them to drastically slash benefits, increase taxes, or both.

Report Highlights:

• The Republican plan could force as many as 30 million Americans off of Medicaid.
• The Republican plan cuts over $1.7 trillion from health care services provided through Medicaid, including $550 billion in health care for seniors and the disabled.  As a result, nursing homes across the country could be forced to slash services, turn away seniors, or close their doors.
• The Republican plan would shift costs to state taxpayers at a time when 41 states already face a budget crisis.  This could lead to huge tax hikes on taxpayers in states across the country.

The Republican budget also doubles-down on their effort to end Medicare as we know it. Under their plan, over 45 million soon-to-be seniors would be forced out of Medicare’s guaranteed benefits and onto a voucher, and out-of-pocket costs for the typical senior could go up by nearly $6,000.  The DPCC national report and state-by-state breakdown on the impact on Medicare can be found below:

National
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming

Having grown up in a family that could not afford health care, I know how difficult it can be to go to a doctor when you need one.

That’s one of the reasons I worked on health insurance reform. No person in the United States should go without care when they need it.

I remember an afternoon in October 1951 when my 10-year-old brother Larry fell off his bike and broke his leg. There was no money for a doctor. His leg was never set, and it eventually healed crooked.

Doctor visits were not an option in my home — not for us kids and not for my parents either. My mother’s teeth fell out one by one because she never could pay to see a dentist. She had to gum her food and couldn’t eat the meat we had, so we ate a lot of beans and rice.

Last year’s health insurance reform law provides benefits to seniors on Medicare, people with preexisting and chronic conditions, and small businesses. We have eliminated lifetime limits and made preventive care more affordable.

When writing the law, we knew it would take time to implement, and we worked to minimize the number of people who would have lost coverage before health insurance reform was fully enacted. We provided funding for employers to continue early retiree coverage and gave tax credits to small businesses — both groups were susceptible to losing coverage in the current system.

And we wanted to ensure that low-income children, the elderly, and people with disabilities would be protected, so we included an important provision requiring states to keep Medicaid and the Children’s Health Insurance (CHIP) strong. It prevents states from cutting Medicaid coverage for adults prior to January 1, 2014 and protects children’s coverage in Medicaid and CHIP through 2019.

Unfortunately, my Republican colleagues have introduced a bill that would unravel these stability protections, possibly denying hundreds of thousands of women and children access to health care provided through Medicaid and eliminating or cutting the Children’s Health Insurance Program, depending on the state.

Republicans argue that cutting kids and parents from Medicaid saves money. In fact, such cuts would prove quite costly. Hospitals, community health care centers, and other providers would have increasing rates of uncompensated care, leading to increased costs for everyone else.

By 2013, 400,000 deserving people — two-thirds of them children — would lose vital health care services under the Republican plan, according to the Congressional Budget Office.

The stakes get even higher in 2014. That’s when Medicaid will expand. The lowest-income citizens will be eligible for Medicaid coverage. We will truly see a decline in the uninsured in this country. But if the Republican plan becomes law, the Congressional Budget Office estimates 1.7 million children would lose health insurance by 2016. Half the states could entirely eliminate their CHIP programs, while remaining states would dangerously roll back coverage.

Medicaid and CHIP provide care for Americans who cannot afford it. Most recipients are women and children. The Republican plan would let states drastically limit enrollment and eligibility rates — and must be opposed.

There are a lot of people today who are just like my mother and brother — people who cope with unnecessary pain because they lack money. In Nevada, for instance, nearly 250,000 people rely on health services through Medicaid that they otherwise could not afford.

Medicaid and CHIP exist to provide mothers and children, among others, the safety net they need. These programs have helped reduce the child uninsured rate by more than half, to less than 10 percent, over the last decade. Without them, the health of low-income Americans would be much worse.

Helping people treat conditions that may become life-threatening is far less costly than helping people whose conditions have already reached a critical stage.

This July marks the 46th anniversary of Medicaid, an opportunity to reflect on the millions of Americans whose lives are supported or saved, thanks to its existence.

There is no better way to mark this anniversary than by making sure we keep Medicaid strong and viable, and oppose attempts to weaken it.

Voters Dislike GOP Plan to Change Medicare, Medicaid

By Patrick O’Connor

Republicans have some selling to do.

Changes to Medicare and Medicaid remain wildly unpopular and more than two-thirds of registered voters want to repeal Bush-era tax cuts for households that make more than $250,000 a year, according to the latest Quinnipiac University poll.

More than twice as many voters oppose efforts to change Medicare than those who favor limiting benefits under the popular health-care program for seniors. And a distinct majority opposes new limits on Medicaid, the federal-state health program for the poor.

What’s worse for the GOP, the numbers don’t change much when voters were told how much federal spending Medicare and Medicaid consume.

Quinnipiac told half of the 1,408 registered voters the university polled that Medicare, Medicaid, Social Security and defense spending consume 60% of the budget. The other half weren’t. Among those who were told, 70% opposed efforts to change Medicare, compared with the 75% who weren’t told. For Medicaid, 57% of the first group opposed limits, compared with the 59% of the control group that also opposed changes. The only significant change came on the question of defense spending, with support for cuts increasing by 7% when voters were told how much the government spends on the military.

“So much for the idea that if the public only understood the budget numbers they would be much more amenable to reductions,” said Peter Brown, assistant director of polling at the Quinnipiac University Polling Institute. “Except for defense spending.”

The House Republicans’ budget would turn Medicaid into a system of block grants to the states and transform Medicare from a fee-for-service program to a menu of subsidized private insurance plans for people under the age of 55. Many GOP lawmakers got an earful from their constituents about the budget blueprint during a recently concluded two-week recess.

In addition, 69% of the voters polled favor repealing Bush-era tax breaks on households than earn more than $250,000. Republicans would keep the current rates indefinitely, while President Barack Obama has promised to raise them for people whose income exceeds $250,000.

http://blogs.wsj.com/washwire/2011/05/04/voters-dislike-gop-plan-to-change-medicare-medicaid/

“The Ryan Republican budget has three pillars: reduce Medicare benefits by more than half; reduce Medicaid benefits for seniors in nursing homes; and reduce taxes on the wealthiest Americans. America can resolve its budget crisis without punishing the elderly and poor while rewarding the very rich.”

“Shutting down government is apparently not enough, now Republicans have taken aim at shutting down Medicare as we know it. The bottom line on the Republican plan is that it would dismantle Medicare for tens of millions of Americans. I’m also deeply concerned that the Republicans’ budget seeks to meet their ‘moral obligation’ to cut the deficit by cutting health care for children on Medicaid. We must do everything we can to responsibly reduce our nation’s debt and keep our economy on the path to prosperity, but we draw the line at penalizing seniors and children for an economic mess they did not create.”

Myth: Medicaid expansion under the Affordable Care Act will bust state budgets.

Reality: Independent, non-partisan analyses suggest that the Affordable Care Act will produce savings and increased revenues for states.

On March 1, 2011, Republicans released an erroneous report on the costs to states of the Medicaid expansion under the Affordable Care Act. The DPCC Fact Sheet provides information demonstrating how Republican projections are flawed and provides information on recent Administration efforts to ensure state flexibility during implementation.

I. Background on Medicaid Expansion:

The Affordable Care Act fixes our health insurance system while dramatically increasing access for families to affordable, high-quality coverage.  By 2021, the Affordable Care Act will reduce the number of Americans under age 65 without insurance by about 33 million, meaning that 95 percent of legal residents under age 65 will have health insurance coverage. Approximately 23 million of these newly insured Americans will purchase their health insurance through new health insurance Exchanges.  [CBO, 2/18/2011]

The remaining newly insured will obtain coverage through Medicaid and the Children’s Health Insurance Program (CHIP).  Under the Affordable Care Act, Medicaid will be expanded to all individuals under age 65 with incomes at or below 133% of the federal poverty level, thus creating a minimum standard eligibility across states.  All Americans over age 65 will continue to be covered by Medicare.

II. What Percent Do States Actually Pay?

The federal government will cover 100% of the costs to states for the newly eligible population for the first three years, between 2014 and 2016.  The federal government will then cover 95% of all costs costs in 2017, 94% in 2018 and 93% in 2019.  In 2012 and for every year following that, the federal government will pay 90% of all costs for the newly covered Americans.

States will only pay a tiny fraction of the costs to cover the newly insured population. According to the CBO, states will pay only eight percent of the total cost of the 18 million people who will be covered by Medicaid and the Children’s Health Insurance Program between 2012 and 2021, as a result of the new law.  CBO further found that the federal government will pay 92 percent of the $734 billion total cost for this coverage.  CBO has previously found that the entire cost of the legislation, including changes to Medicaid, is fully paid for and reduces the deficit by more than one trillion dollars over the next two decades.  [CBO, 2/18/2011]

III. Republican Accusations on State Medicaid Costs:

Republicans estimated that the expansion will cost state taxpayers an additional $118.4 billion through 2023.  The Republicans’ assertion is about twice the independent Congressional Budget Office estimate of $60 billion through 2021.  The Congressional Budget Office has long been the independent, official scorekeeper of the effects of Congressional legislation. [Republican Congressional Report, 3/1/2011]

What are outside groups saying about the Republicans Accusations?

• The report ignores independent, non-partisan analyses that account for the savings and increased revenues the Affordable Care Act will produce.  These savings could amount to more than $160 billion across all states. [Lewin Group, 12/1/2010]
• Republicans projections cherry-pick “worst-case scenarios from various studies that use different time frames and rely on flawed assumptions.” [CBPP, 3/1/2011]

IV. Rationale for Variation of State Medicaid Costs:

While Republicans highlight an inflated estimate regarding the Medicaid expansion cost to states, other independent, non-partisan analysis showsasavings of $106.8 billion. [Lewin Group, 12/1/2010] According to Kaiser, “There are a number of reasons why the estimates of the ACA on states varies so widely. Expanding Medicaid naturally costs more in states where there are more uninsured residents with Medicaid income levels, and the magnitude of the estimates tend to be larger in high-population states. Moreover, the estimates use different methodologies in projecting costs of new enrollment and in including or omitting other costs, savings, or revenues.” [Kaiser, 2/1/2011]

Republican Projections Exclude Health Reform Savings and Revenue to States

• Republicans projections fail to account for reductions in state support for uncompensated care,“ACA-driven increases in coverage will reduce uncompensated care, especially for public hospitals and clinics, along with private safety net institutions. States could share in the associated savings by making changes in the various ways that they support localities and safety net institutions. No state report estimates savings of this type, perhaps in part because of the complexity of funding flows, although two of our five recognize that they will occur… The national estimates from the Lewin Group and from Dorn and Buettgens projected very large savings of this type, up to $100 billion over ten years, enough to generate overall net savings to states under the ACA, although savings will vary by state.” [Kaiser, 2/1/2011]
• According toRep.  Henry Waxman (D-Ca.), ranking member of the Energy and Commerce Committee, “All of these estimates overstate state costs because they do not include savings from reductions in states’ payments for uncompensated care. For hospitals alone, the spending for uncompensated care in 2009 was estimated to be $40 billion.” [NJ, 3/1/2010]

• Republican estimates do not account for revenue to states from taxes on insurance premiums. According to Kaiser, “Such revenues will be higher because the extent of insurance coverage will rise under the ACA. Maryland’s revenue estimate found that this would generate over two-thirds of the net savings that the state projected.” [Kaiser, 2/1/2011]

• Republican projections do not account for savings tostate programs. According to Kaiser, “The expansion of coverage and benefits under the ACA will very likely mean that people will seek much less care from existing state and local programs, such as those now funded through public health or mental health departments. States that operate high-risk pools should also see reduced demands and therefore savings in these programs.” [Kaiser, 2/1/2011]

• Republicans fail to account for savings through increased efficiency or enhanced value through initiatives in care management, coordination, and payment methods.According to Kaiser, “For example, the ACA provides a new health home initiative to better coordinate care for individuals with chronic conditions with 90 percent match rate for these services. The ACA also allows states to integrate care for ‘dual eligibles,’ people jointly enrolled in Medicaid and Medicare, and thereby improve value or efficiency… Many different opportunities exist to obtain federal funding such as grants, incentive payments, or demonstration support.” [Kaiser, 2/1/2011]

Republicans Use Studies with Different Timeframes and Flawed Assumptions

• Republicans use worst-case scenarios from studies in order to project high costs to states.According to CBPP, the GOP report, “… doesn’t mention that the Urban analysis produced two sets of estimates for each state — one assuming that the Medicaid participation rate would remain at about its current level, and another assuming that it would rise significantly.  Most credible analysts use the lower estimate, but the GOP report references only the higher one.” [CBPP, 3/1/2011]

• Republicans use studies with flawed assumptions.“The report’s cost estimates for Indiana, Mississippi, and Nebraska come from misleading studies conducted by the consulting firm Milliman, Inc. that rely on flawed assumptions.  One estimate assumes that literally everyone who becomes eligible for Medicaid under health reform will sign up for it on Day 1 — something that has never happened in a means-tested public program.” [CBPP, 3/1/2011]

• Republicans extend the timeframe to manipulate the numbers. The report extends the time frame for the estimate by two years to make the numbers look larger.  This exaggeration misleads the reader by providing an apples to oranges comparison.  The standard time frame used by CBO is 10 years, from 2012 through 2021. This report uses a 12 year time frame, from 2012 through 2023, artificially raising the estimate.

• Republicans rely on studies which include costs not related to the Affordable Care Act.“For example, its Utah estimate comes from a state report that seems to assume enhanced federal funding will run out by 2014, forcing Utah to shoulder a larger portion of the expansion’s costs.  Its Florida estimate, also from a state report, not only assumes that 100 percent of newly eligible individuals will enroll but also includes the cost of raising Medicaid’s payment rates for primary care to Medicare levels after 2014 — a change the health reform law does not require.” [CBPP, 3/1/2011]

V. Other Estimates on State Medicaid Costs:

Republicans contend that the Medicaid expansion under the Affordable Care Act will bust state budgets.  They argue that this expansion will cost state taxpayers billions through 2023, with Texas ($27 billion between 2014-2023), Florida ($12.9 billion between 2014-2023), and California ($19.4 billion between 2018-2023) accounting for the majority of the costs.

The Kaiser Commission on Medicaid and the Uninsured recently conducted an analysis of these and other estimates. As demonstrated below, the estimates range from a multi-year total cost of $27 billion in Texas to savings of over $106 billion across all states. [Kaiser, 2/1/2011]

[Kaiser, 2/1/2011]

VI. Governors agree that expanded Medicaid eligibility and increased flexibility benefit states:

Testifying before the House Ways and Means Committee on the Medicaid expansion, Governor Deval Patrick stated “Federal reform is good for Massachusetts, it has given us an affordable way to extend the promise of coverage to Massachusetts residents.” [WP, 3/1/2011]

A number of states, including Connecticut, Minnesota, Washington, and the District of Columbia, have been approved to expand Medicaid eligibility ahead of the 2014 deadline.

• Minnesota Governor Mark Dayton explained the benefits of the changes, “As my first official act as Governor, I’m going to take two important steps. One is to sign an executive order, committing Minnesota to the so-called Early Option for Medicaid…This is a step that benefits all of the people of our state at no, and I repeat no, net cost to the state of Minnesota.”

VII. The Administration is working to ensure that States have the flexibility to secure savings and increase state revenue:

• Under the Affordable Care Act, States may structure their Medicaid programs to more closely resemble the private insurance coverage options available in the Exchanges. States can tailor the benefit packages based on private coverage options available in their States – such as the standard Blue Cross/Blue Shield plan, the State employee health plan, and the largest commercial HMO available in the State. States can go beyond these standards to provide additional benefits but are not required to do so.
  • Governor Martin O’Malley argues, “We in the State of Maryland greatly appreciate Secretary Sebelius’ understanding of the extraordinary budget pressures all governors now face, and her commitment to working with us collaboratively to reduce costs in our Medicaid programs… I welcome Secretary Sebelius’ offer to help us build on our existing efforts here in Maryland to improve quality of care while saving significant Medicaid dollars over the short and long term.”[Office of the Governor, 4/4/2011]

Please find additional resources below:

KFF, “State Budgets Under Health Reform”: http://www.kff.org/healthreform/upload/8149_ES.pdf

KFF, “5 Things to Know About Medicaid:” http://www.kff.org/medicaid/8162.cfm

KFF, “Medicaid Enrollment: June 2010:” http://www.kff.org/medicaid/enrollmentreports.cfm

Center for Budget and Policy Priorities: http://www.offthechartsblog.org/republican-report-inflates-state-medicaid-costs-under-health-reform/