Linda Gorman of the Independence Institute explains:

The act makes commercial insurance widely available for both working and nonworking people at all income levels. If it works as advertised, the federally subsidized commercial health coverage offered through the Affordable Care Act health benefits exchange will provide better health coverage for the basically healthy adults and children who make up the largest part of the Colorado Medicaid caseload. It will do this at no cost to the state, provided the state Medicaid program is changed to make those who would benefit from commercial policies ineligible for Medicaid. Under the act, individuals eligible for exchange insurance subsidies cannot access them unless they are ineligible for Medicaid.

Commercial coverage historically has provided better access to care than Medicaid. Commercial policies have reimbursed at significantly higher rates, making it easier to find a physician and to arrange for timely care. …

Under the Affordable Care Act, annual premiums for commercial coverage for people at 100 percent of the federal poverty level ($11,170 in income in 2012) are limited to $217 for a single person.  … According to the 2010 Consumer Expenditure Survey, people in spending groups with under $10,000 a year in pre-tax money income spent about $1,000 on entertainment, $1,000 on food away from home and more than $2,000 on private vehicle transportation. …

Even if the Affordable Care Act didn’t offer the opportunity to make many Medicaid clients better off by switching them to private insurance plans, Medicaid expansion makes little fiscal sense given Colorado’s difficult budget circumstances.

Read more: Medicaid expansion may be more costly than advertised | Health Policy Solutions.