|Kentucky Governor Steve Beshear|
TruthOut: Opinion: A.W. Gaffney: The Problem With the Private Option
You can get on right-wing governors for not expanding Medicaid in their state all you want. But the fact is if Medicaid wasn't an unfunded mandate to begin with which is a Federal program that is forced upon the states through law, but not paid for. Then we aren't seeing this right now and the Medicaid section of the Affordable Care Act probably doesn't get thrown out. Because Medicaid would be fully paid for meaning the Feds could say "you need to expand this program. You have the funds to pay for your current Medicaid costs and here are additional funds to pay for the expansion".
But since Medicaid is an unfunded mandate because the Feds don't cover the costs of Medicaid that they are required to by law states are having a hard time meeting their current Medicaid costs. Let alone having the money there to pay for an expansion. So the Supreme Court says that "the Medicaid expansion is constitutional, but since it is an unfunded mandate and the Feds don't have a very good record at meeting their financial promises, that the states don't have to expand their Medicaid program. And if they decide to do so the Feds have to cover their share of the costs.
The private option in Medicaid is a good idea. Medicaid really should be a state program to begin with and let all fifty states set up their own low-income health insurance system. Instead of the Feds trying to run one system for fifty states in a country of three-hundred and fifteen-million people. The private option is good because it would allow low-income Americans to have more say in their own lives and give them more responsibility and make them less dependent on the state for their survival. It would also cut Medicaid costs because less people and less poor people would be on Medicaid.
I realize anti-federalist Progressives who have this idea that big brother big government the central state should be planning the lives of everyone at least people who do not make enough money to manage their own affairs. And tend to see people especially Americans as stupid who can't make these decisions for themselves. But they are wrong because once Americans have the education and knowledge they are more qualified to make their own decisions then some government office who does not even know who they are.