From: Heartland Institute: The Government Relations Team
To: Dean Sanpei,
Subject: The Leaflet - States Still Considering Medicaid Expansion
Date: Thu Jan 16 18:29:42 MST 2014


States Still Considering Medicaid Expansion


Currently, 26 states have chosen to expand their Medicaid programs as part of Obamacare and 22 states have chosen not to do so. States that have been reluctant to expand Medicaid, like Wyoming and Utah, are still feeling pressure to expand and are considering plans similar to Arkansas’ “private option.” Ultimately, Medicaid expansion is an expensive endeavor that many critics say does not provide better or more affordable health care.

Despite the private market “feel” of the Arkansas model, it is still an expansion of Medicaid, where multiple aspects of the insurance plan are dictated by the federal government. Once expansion occurs, it will be extremely difficult to roll back and there is also no guarantee the federal government will allow the program to continue once it is up for renewal.

Instead of expanding a flawed model that is very costly for taxpayers, delivers subpar health care, and shifts more power to the federal government, state lawmakers should focus instead on reform options like those piloted in Florida that reduce costs and offer better care to patients in the existing system. Read more about Medicaid Expansion here.


Health Care

Research & Commentary: Utah Medicaid Expansion


Utah Gov. Gary Herbert has not yet decided whether to accept federal money for Medicaid expansion. In December, a Legislative Health Reform Task Force outlined and recommended three Medicaid expansion scenarios for the Utah Legislature. The first would keep the status quo and leave the Medicaid eligibility rules unchanged.  The other two plans follow an approach pioneered in Arkansas that would avoid a direct Medicaid expansion but give low-income Utahans public dollars to buy private insurance. In this Research & Commentary, Matthew Glans examines the proposals for Medicaid expansion being considered in Utah. Read More


Budget & Tax

Research & Commentary: Vermont Pension Reform


As unfunded government liabilities have raced out of control, the high cost of traditional defined-benefit public pensions has become a big issue for Vermont. State Treasurer Beth Pearce and economic advisor Tom Kavet have warned legislators and public employees that the state needs to address the $72 million pension shortfall during the next legislative session. In this Research & Commentary, Matthew Glans argues sustainability will require Vermont to follow the private sector’s lead and switch workers from defined-benefit pension systems to defined-contribution-style pension plans like 401ks. Read More



Heartland Institute Experts React to Net Neutrality Ruling by DC Circuit Court


The D.C. Circuit Court recently struck down the Federal Communication Commission’s 2010 “net neutrality” rule requiring Internet service providers to treat all traffic across their networks the same – discriminating against none and favoring none. The court also, however, ruled the FCC may impose its net neutrality rule if it reclassifies broadband as a “common carrier” as it does telephone service. Read More



States to Watch in 2014


Leslie Hiner of the Friedman Foundation says look toward Tennessee and Oklahoma for early action on school choice. “Oklahoma lawmakers are discussing Arizona-style education savings accounts (ESAs) and Tennessee lawmakers will have to decide between statewide vouchers and those limited to urban areas,” writes Joy Pullmann, research fellow for The Heartland Institute. Since The Wall Street Journal dubbed 2011 “the year of school choice,” the momentum states have experienced in enacting school choice laws has continued unabated. Read More



Tip Sheet: Hydraulic Fracturing


A new Heartland Policy Tip Sheet examines the impact high-volume hydraulic fracturing and horizontal drilling technology have had on local environments, state economies, and the national energy outlook. The Tip Sheet summarizes many major points made in a recent Heartland Policy Study on hydraulic fracturing and includes useful “Policy Messages” for legislators in states like California, Colorado, Illinois, and North Carolina, which are expected to discuss the issue this year. Read More





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The January issue of School Reform News reports school choice advocates in Iowa aim to expand the state’s tax-credit scholarships and develop education savings accounts (ESAs). Legislators “really helped push some great educational liberty pieces” last year, according to political strategist Shane Vander Hart.

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Heartland Institute

The Heartland Institute is a 29-year-old national non-profit organization dedicated to discovering, developing, and promoting  free-market solutions to economic and social problems.


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