To many people, an Obamacare expansion sounded like a good plan. Under Obamacare, the former president decreased the qualifying income amount, thus making millions of more people eligible for Medicaid. The social program was always income-based, but also needs to take care of disabled individuals. But was it a good idea to lower the income requirement?

A new report from the Foundation for Government Accountability (FGA), a conservative think tank, suggests that the expansion has taken away much-needed resources from people who genuinely need Medicaid. In fact, the FGA claims that so many resources have been diverted, they estimate that over 20,000 Americans have died while waiting for Medicaid services.

Enrollment has been drastically delayed, and people are literally dying while waiting to enroll. Certainly the expansion of Obamacare is not the only culprit, but it is a contributing factor to the problem. FGA estimates that 650,000 individuals are now on the Medicaid waiting list.

The issue is that now, thanks to Obamacare expansion, more than 28 million non-disabled adults received a fast track to enrollment. Those resources are being utilized, and people on the waiting list are waiting longer and longer.

In its report, the FGA focused on one specific area—the Home and Community-Based Services (HCBS) waiver program and resulting waiting lists. The HCBS program was created in 1981 and allows each of the 50 states the option of providing Medicaid services to individuals in their home or community. This means that the individuals receiving Medicaid do not have to be at a nursing home or other similar location.

Historically, recipients of the HCBS benefits tend to be people with traumatic brain or spinal cord injuries or people with severe mental illness or intellectual disability. Forty-seven of the 50 states use Medicaid to provide services to these patients in their homes. However, the states have leverage to cap enrollment; people are added to waiting lists when the cap is exceeded. Thanks to Obamacare expansion, the caps are always met or exceeded. Unfortunately, 38 states have waiting lists with thousands of people waiting. In Louisiana alone, nearly 75,000 people are waiting for Medicaid services.

The FGA report focused on similar data from each state. When FGA added it all up, they estimate that nearly 22,000 people have died waiting for Medicaid services. FGA says the number may be even higher because many states had incomplete data.

Incredibly, people can wait as long as ten years to get Medicaid services. FGA says that for New Mexico, the waiting time has been 10.2 years in some cases.

Why?

Because Obamacare expansion did just that—it expanded Medicaid far beyond its original purpose. “Able-bodied” adult enrollment has quadrupled, growing from seven to 28 million. FGA says there are 17.5 million more non-disabled adults than disabled adults on Medicaid now.

The Obamacare expansion means that adults now have a much lower financial requirement to qualify for Medicaid—income of 133 percent of the federal poverty level, compared to 150 percent. This is why there are so many people now on Medicaid, and explains why those resources are being diverted away from people on the waiting lists.

States did have the option of choosing whether to expand Medicaid under Obamacare. Many states did, and as a result, 250,000 of the 650,000 wait-listed are from states that chose the expansion. For example, when Ohio elected to expand under Obamacare, it added approximately 62,000 people to their list. Some states like Texas did not, because the federal subsidy would end after two or three years, and then the skyrocketing costs will need to be absorbed by the state. Texas said, “No thanks.”

FGA concludes by saying that Medicaid has lost its focus and Obama can be thanked for that. It has changed from a program for people who truly need Medicaid to survive—blind and severely disabled people—to yet another entitlement program. FGA research director Nicholas Horton described Medicaid as a system that has “gotten really out of whack, and lost its priorities.”

What to do?

The FGA proposes three remedies.

First, end the Obamacare expansion. Some states are finally waking up to what Texas already knew and are considering ending the expansion in their states.

Second, add a work requirement for the non-disabled. Many states have done it.

Third, states must deal with welfare fraud—a problem that costs billions of dollars nationwide. Deterring fraud means billions back to recipients who really need it.

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