With round two of Obamacare enrollment here, New York’s policymakers should take stock of where the Empire State is and where it’s heading.Take the state’s Medicaid program. Post-Obamacare, Medicaid enrollment has grown by over 7 percent to 6.1 million people: nearly 1 in 3 New Yorkers now receive coverage through the joint federal-state insurance program for the poor. New York’s Medicaid spending, among the highest in the country, makes up about 30 percent of the state budget.New York has reached a pivotal juncture.
Medicaid can evolve for the better—from a special-interest-driven relic to a proving ground for how competition and innovation create effective cost-controls by embracing new ideas. Or Medicaid can continue for the worse—further entrenching its position as a de facto slush fund for politically connected providers and health care unions.One can, in fact, find evidence for both.