Medicaid expansion: how bad an idea?

Two state directors of Americans for Prosperity - representing states in which the legislatures had the good sense to shoot down Medicaid expansion - provide a rundown in today's WSJ of how things have turned out in states that went ahead with it:

Consider the experience of the states that did expand Medicaid. “At least 14 states have seen new enrollments exceed their original projections, causing at least seven to increase their cost estimates for 2017,” the Associated Press reported in July.

The AP says that California expected 800,000 new enrollees after the state’s 2013 Medicaid expansion, but wound up with 2.3 million. Enrollment outstripped estimates in New Mexico by 44%, Oregon by 73%, and Washington state by more than 100%.

This has blown holes in state budgets. Illinois once projected that its Medicaid expansion would cost the state $573 million for 2017 through 2020. Yet 200,000 more people have enrolled than were expected, and the state has increased its estimated cost for covering each. The new price tag? About $2 billion, according to the Chicago Tribune.

Enrollment overruns in Kentucky forced officials to more than double the anticipated cost of the state’s Medicaid expansion for 2017, the AP reports, to $74 million from $33 million. That figure could rise to $363 million a year by 2021.

In Rhode Island, where one-quarter of the state’s population is now on Medicaid, the program consumes roughly 30% of all state spending, the Providence Journal reports. To plug this growing hole, Rhode Island has levied a 3.5% tax on insurance policies sold through the state’s ObamaCare exchange.

Even Ohio, whose Republican Gov. John Kasich is running for president on a platform of fiscal responsibility, finds itself in a Medicaid bind. State spending on the program has grown by $5.8 billion since 2011. The Ohio Department of Medicaid projects that by 2017 spending will total $28.2 billion—a 59% increase during Mr. Kasich’s tenure.

In what universe its it a sane idea to take a citizen's money, run it through the DC bureaucratic filter, send it back to the state where the citizen lives, run it through that bureaucratic filter, invite too many fellow citizens to belly up to the trough to get some of it, and expect anybody's health to get cared for?