Texas Insider Report: AUSTIN Texas Heres the problem" says Iowa Governor Terry Branstad. The federal government has done this again & again: Buy into our program and were going to do all these things for you. Then it doesnt happen and the taxpayers of the state get stuck with it."
A week after the Supreme Court opened the door for states to opt out without jeopardizing federal dollars they already receive a growing number of Republican governors say they will keep their states out of the federal health care laws massive Medicaid expansion.
Already governors in Kansas Nebraska and South Carolina among other states have said they would have difficulty affording even the comparatively small share of costs that states would eventually have to pay.
Gov. Dave Heineman of Nebraska a Republican who is chairman of the National Governors Association indicated that he was against expanding Medicaid eligibility.
As I have said repeatedly if this unfunded Medicaid expansion is implemented state aid to education and funding for the University of Nebraska will be cut or taxes will be increased" Mr. Heineman said.
In South Carolina Rob Godfrey a spokesman for Gov. Nikki R. Haley said Were not going to shove more South Carolinians into a broken system that further ties our hands when we know the best way to find South Carolina solutions for South Carolina health problems is through the flexibility that block grants provide."
In New Hampshire State Representative Andrew J. Manuse said he and other Republicans were already working to block the expansion of Medicaid. We cant afford it" Mr. Manuse said. Its as simple as that. Thank God the Supreme Court gave us an option."
Shortly after the ruling was announced a number of GOP governors who are prominent critics of President Obamas health care law reveled in the courts Medicaid decision the sole victory for the health laws opponents. Republicans such as Governor Bobby Jindal of Louisiana and Wisconsin Governor Scott Walker were quick to say they wouldnt implement any part of the federal law and would work for its repeal.
The New York Times in an article entitled How Much Would the Medicaid Expansion Cost Your State? compiled data this week from the Kaiser Family Foundation which projects how the Medicaid expansion would affect federal and state spending in each state.
According to Kaiser most states opting into the expansion would have to ramp up their Medicaid spending between 2014 and 2019 but four wouldspend less (Hawaii Maine Massachusetts and Vermont) and several others would have to boost state spending only slightly.
The Obama administration has dismissed the idea that states will walk away from the federal money that comes along with the Medicaid expansion. But The Hill newspaper says Republican lawmakers and Medicaid officials in at least 15 states have pledged to do just that.
These states would forfeit billions in federal aid and decline health coverage for millions of their uninsured residents. The Medicaid expansion is intended to cover as many as 17 million people nearly half the laws total increase in coverage and Washington would pay the entire cost from 2014 to 2017 and 90 percent after that.
Even some officials who believe the federal government will fulfill its financial promises say they will opt out of the Medicaid expansion.
Texas for example has put its estimated costs from the expansion as high as $27 billion over the first decade a figure officials call too steep for its budget.
And Florida Governor Rick Scott said Monday even 10 percent of the cost was too much for his state to bear.
Still that arrangement hasnt dulled the criticism from some state executives particularly those skeptical of adding any more costs to a Medicaid program that is already eating up a significant chunk of state 
budgets.
Florida will opt out of spending approximately $1.9 billion more taxpayer dollars required to implement a massive entitlement expansion of the Medicaid program" Scott announced. He said the states Medicaid spending was already growing three-and-a-half times as fast as Floridas general revenue."
How much each state might spend and how much its Medicaid rolls might increase under the law has been up for debate since it was signed.
Even the New York Times article estimates depend on assumptions of how many newly eligible people will enroll in the Medicaid expansion. According to a 2010 Kaiser Family Foundation report states share of the Medicaid expansion could range from $20 billion to $43 billion in the first five years depending on how many people ultimately enroll.
Shortly after the ruling was announced a number of GOP governors who are prominent critics of President Obamas health care law reveled in the courts Medicaid decision the sole victory for the health laws opponents. Republicans such as Governor Bobby Jindal of Louisiana and Wisconsin Governor Scott Walker were quick to say they wouldnt implement any part of the federal law and would work for its repeal.
The New York Times in an article entitled How Much Would the Medicaid Expansion Cost Your State? compiled data this week from the Kaiser Family Foundation which projects how the Medicaid expansion would affect federal and state spending in each state.
According to Kaiser most states opting into the expansion would have to ramp up their Medicaid spending between 2014 and 2019 but four wouldspend less (Hawaii Maine Massachusetts and Vermont) and several others would have to boost state spending only slightly.
The Obama administration has dismissed the idea that states will walk away from the federal money that comes along with the Medicaid expansion. But The Hill newspaper says Republican lawmakers and Medicaid officials in at least 15 states have pledged to do just that.
These states would forfeit billions in federal aid and decline health coverage for millions of their uninsured residents. The Medicaid expansion is intended to cover as many as 17 million people nearly half the laws total increase in coverage and Washington would pay the entire cost from 2014 to 2017 and 90 percent after that.
Even some officials who believe the federal government will fulfill its financial promises say they will opt out of the Medicaid expansion.
Texas for example has put its estimated costs from the expansion as high as $27 billion over the first decade a figure officials call too steep for its budget.
And Florida Governor Rick Scott said Monday even 10 percent of the cost was too much for his state to bear.
Still that arrangement hasnt dulled the criticism from some state executives particularly those skeptical of adding any more costs to a Medicaid program that is already eating up a significant chunk of state budgets.
Florida will opt out of spending approximately $1.9 billion more taxpayer dollars required to implement a massive entitlement expansion of the Medicaid program" Scott announced. He said the states Medicaid spending was already growing three-and-a-half times as fast as Floridas general revenue."
How much each state might spend and how much its Medicaid rolls might increase under the law has been up for debate since it was signed.
Even the New York Times article estimates depend on assumptions of how many newly eligible people will enroll in the Medicaid expansion. According to a 2010 Kaiser Family Foundation report states share of the Medicaid expansion could range from $20 billion to $43 billion in the first five years depending on how many people ultimately enroll.
