Fiscal Objections to Expanded Health Coverage

Now that the Supreme Court has upheld the Affordable Care Act (ACA), the next major policy decision is whether the states should expand Medicaid. This chapter considers a fiscal objection to the expansion, and it draws three main conclusions. First, some people could reasonably believe the assumptions behind the fiscal objection and thus reasonably oppose the Medicaid expansion. Second, despite the fact that reasonable critics could hold those assumptions, most critics do not, and so they should not reject the Medicaid expansion on these fiscal grounds. Third, supporters of the ACA and the Medicaid expansion can reasonably reject the assumptions behind the fiscal objection and thus the objection itself.