The general rule of politics, it seems, is that the crappier a government program, the harder it is to reform—much less scrap. That is the case with Medicaid,
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arguably the civilized world's worst health insurance program, I note in my column at The Week.
But instead of fixing this program, President Obama expanded it obscenely to the point that Obamacare covers far more uninsured through it than private health plans sold on the exchanges.
This is terrible news for the health of this country given that Medicaid patients show worse health outcomes than even the uninsured. Liberals rant that Republican efforts to repeal Obamacare would kill Americans. But as far as this program is concerned, the opposite might be closer to the truth.
The only reason 31 states and the District of Columbia agreed to expand Medicaid was that Obamacare offered them a deal they couldn't refuse. Nineteen still valiantly resisted in a rare show of fiscal courage.
But these holdouts now will make GOP's plans to repeal-and-replace efforts infinitely more complicated. Thanks to them, the politics of rolling back the Medicaid expansion will be even more toxic than scrapping the exchanges – which is why it will be an absolute miracle if Republicans go through with anything but the most watered down fixes.
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