by Joseph Antos
American Enterprise Institute
April 14, 2014
Under the Affordable Care Act (ACA), states have been given the authority to decide whether to expand eligibility to their Medicaid programs to cover anyone below the eligibility threshold for ACA subsidies. Medicaid spending, already a large state expenditure, will increase dramatically—perhaps by as much as 12 percent in 2014—if states choose to expand their programs. The federal government should change the Medicaid program to allow more state-level reform and innovation that will both improve budget efficiency and protect vulnerable populations.

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