Expanding Medicaid does NOT mean covering additional medical conditions or increasing payments to doctors and hospitals. It means covering more people. Medicaid is a poverty/welfare program, not a middle class handout that "expansion" will turn the program into.

Most blue state adopters of expansion already had programs in place going beyond the Federal exemption limit, so Virginia is not really losing out on "free" federal money. Medicaid expansion funding is best described as the gift of a baby elephant. If you accept it, you must feed it, and as it grows it will eat more and more.

Adjusted for inflation, Medicaid spending has increased more than 250% since 1990. Expanding it would cost states an additional $118 billion through 2023, according to a congressional report [1].

The federal government pays 55 percent of total administrative costs, with the other 45 percent paid by the states [2].

Only 45% of urban doctors are seeing Medicaid patients ... and that's before recent cuts in reimbursements [3].

Fraud: GAO shows high levels of fraud, and that's before the expansion of Medicaid [4].

Know how Medicaid mills run? Since reimbursement rates are so low, some doctors and clinics prescribe unnecessary, but billable, tests and procedures to make up for the low payments they receive. Bigger programs = more fraud. What percentage do you think law enforcement catches?