But who pays the bill?

The Obama administration seems to believe it can create access to medical care out of thin air.

It has proposed a rule to make it hard for states to limit Medicaid payments to hospitals and doctors - no matter how serious the states' financial condition may be.

Medicaid is funded jointly by the federal and state governments. But the problem is, its reimbursement rates are so low that many physicians will not accept new Medicaid patients.

At the same time, state budgets are in desperate condition, so states are attempting to save money wherever they can. To make ends meet, many states are freezing Medicaid payments or are proposing Medicaid cuts - along with cuts to numerous other important programs.

In other words, the states are making the tough choices they have to make to keep their heads above water. (That is a lot more than can be said, by the way, for our federal government, which is $14.3 trillion in the red.)

But the Obama administration wants to block some state Medicaid cuts and force the states to come up with health care dollars they just don't have.

We want all Americans to have the medical care they really need, but it costs money. "Free" health care is a myth. By putting the Medicaid part of state spending more or less off-limits, the administration will force states to shuffle already-limited dollars out of other vital programs - such as education - so they can spend more on Medicaid.

And if states are struggling to meet their Medicaid obligations now, what happens in 2014 when ObamaCare forces them to vastly expand Medicaid coverage?

Deciding how to spend limited state dollars is not easy or pleasant. But the states know better than Washington what their budget priorities should be. The last thing they need is one more unfunded health care mandate.

Upcoming Events