Republican vice-presidential nominee Mike Pence, while campaigning with Donald Trump, is again urging a complete repeal of Obamacare, echoing Trump’s view that it is an unmitigated disaster. Pence a couple of years ago struck a deal to expand Medicaid pursuant to the provisions of Obamacare in exchange for some waivers. Is he a hypocrite for now calling for its total repeal?
In 2014, Forbes magazine reported on the Indiana governor’s decision to expand Medicaid under Obamacare:
By definition, Medicaid block grants give states a fixed, lump sum of federal dollars in exchange for broad autonomy in providing Medicaid benefits. Pence’s plan features neither of these elements. Under Pence’s ObamaCare expansion, Indiana will draw down increasing amounts of ObamaCare in exchange for adding more people to the Medicaid rolls.
And as we pointed out previously, the Pence plan delivers ObamaCare Medicaid benefits, with ObamaCare Medicaid cost-sharing, to the ObamaCare Medicaid expansion population. It’s the worst of all worlds for taxpayers—Indiana’s Medicaid expansion under Pence’s plan will be a blank check with no real incentive or flexibility to control costs.
Pence defended the expansion on the grounds that he attached a work component via a waiver from the Department of Health and Human Services. Forbes didn’t buy it:
There is no work requirement for Indiana’s Medicaid expansion. This is a big departure from other taxpayer-funded welfare programs like TANF cash assistance, in which non-disabled, childless adults do not qualify for benefits at all and low-income parents must work between 20 and 55 hours a week.
What’s worse, Pence’s Medicaid expansion plan will likely discourage work because of its massive tax cliffs. Individuals will be incentivized to reduce their hours or drop out of the labor force entirely, because earning more income could force them to give up thousands of dollars in benefits.
In sum, Pence did in fact extend a new Obamacare-based entitlement to Hoosiers who did not previously receive benefits.
That is not to say Pence did not accomplish some positive market-oriented reforms. (“Enrollees earning above the poverty line could be locked out of coverage for six months for failing to make monthly payments, which could be as little as $1 depending on income. The state also charges co-pays as high as $25 for people who visit the emergency room inappropriately, and the program is exempt from a long-standing Medicaid policy to retroactively cover new enrollees’ medical bills for up to three months before they applied for coverage.”) But he still accessed Obamacare benefits, and he did not achieve anything approaching block grants.
Pence could have argued that he would take advantage of Obamacare so long as it was the law of the land (like Trump taking every tax break) but that he’d repeal it and find something better. Instead he kept insisting that his state really hadn’t benefited from Obamacare. That’s not true. In fact, none other than Mike Pence brags that his plan was a smashing success.