On the recordSeptember 21, 2012
the Supreme Court decision on the Affordable Care Act has put the brakes on Medicaid expansion for now. The Federal Government can no longer force States to expand their Medicaid programs. With the expansion and the billions of dollars that States would have had to spend on hold, and as we look at solutions to address our 16 trillion dollar national debt, now is a good time for us to step back and ask what role health care should play for States in our Federal system. Mr. President, as of today, the primary function of a state is health administration--not primary and secondary education, not public safety, not roads and bridges. According to the National Association of State Budget Officers, Medicaid is the single largest spending line in state budgets at 23.6 percent. The economic downturn and high unemployment have resulted in an increase in Medicaid enrollment as individuals lose job-based coverage and incomes decline. Medicaid enrollment increased by 5.1 percent during fiscal 2011 and is estimated to increase by 3.3 percent in fiscal 2012. In governors' recommended budgets for fiscal 2013, Medicaid enrollment would rise by an additional 3.6 percent. This would represent a 12.5 percent increase in Medicaid enrollment over this three year period. Medicaid enrollment surged during the economic downturn with enrollment rising by 7.2 percent from June 2009 to June 2010.…





