Maryland advocates and policymakers are rallying behind a plan to expand Medicaid in the state. Apparently they aren't reading the news too closely, though. Not only is Maryland facing a deficit but the feds are looking for ways to cut back on Medicaid spending. For instance, CMS recently set strict limits on expanding SCHIP coverage to middle class and rich kids and adults. Of course, Maryland is looking to expand the Maryland Children's Health Program up to 400% of FPL. One of the arguments used to push for this expansion is that the feds will pay for most of it. If CMS's rules aren't overturned, state policymakers can't count on the federal money. Advocates don't seem to realize this.

And, of course, Maryland just got in trouble with the feds for improperly billing Medicaid for certain special education services. At a time when the feds are looking to cut back on certain types of Medicaid spending and when the state is facing a huge deficit, it makes little sense to expand the program. But since when did common sense have anything to do with Medicaid spending?