Benefits of Medicaid Expansion for All States

Under the Affordable Care Act, states have the opportunity to expand Medicaid coverage to provide millions of Americans access to affordable healthcare. In return, states receive 100 percent of federal funding to cover those costs for the first three years and no less than 90 percent federal support for those costs in the years following. Taken together, if all 24 states that haven’t expanded coverage did so, about 5.4 million uninsured Americans would gain access to health insurance coverage by 2016.

This leaves state officials facing a critical decision: play political games and continue to block Medicaid expansion under the Affordable Care Act or put partisanship aside and bring in much needed funds to allow millions of citizens access to healthcare. It should not be a difficult choice. Now is the time for elected officials to follow the example of Governor John Kasich in Ohio and Governor Jan Brewer in Arizona to put politics aside and expand Medicaid.

As Nebraska State Senator Jeremy Nordquist said:

“It’s often overlooked that Nebraska has a high number of uninsured in rural counties.  Without expansion, rural hospitals will face growing financial challenges, which will undoubtedly lead to a reduction in the services they provide and – we are hearing – a real risk of these critical hospital closing their doors. The good news is that the Nebraska Legislature is unique.  We are nonpartisan, unicameral and constantly find ways to work together to move our state forward.  On this issue, there is a strong bipartisan majority that supports expanding Medicaid.  Providing access to quality, affordable health care should be a priority for all of us who represent the ‘good life’ in Nebraska.  If all legislators and our Governor truly care about growing our economy and strengthening our health care system, we will pass Medicaid expansion in 2014.”

Here’s a sample of some coverage from the last week about local leaders and organizations across the country encouraging leaders to put politics aside, and improve access to quality healthcare by expanding Medicaid:

Washington Times: White House PR blitz hits states that rejected Medicaid expansion The Obama administration’s all-out public relations push to sell its health care reform law increasingly is targeting individual governors, who will bear much of the blame, the White House says, if millions of poor Americans remain uninsured.  Administration officials Monday joined with state and local Democratic leaders in North Carolina to put pressure on Gov. Pat McCrory, a Republican, to expand Medicaid eligibility under Obamacare.  Under Mr. McCrory, North Carolina is one of two dozen states that so far have opted out of that expansion, a crucial building block of the Affordable Care Act but one that became voluntary as a result of a Supreme Court decision last year. LINK 

McClatchy: White House, N.C. Democrats press state to expand Medicaid The White House enlisted two top North Carolina Democrats on Monday to urge Gov. Pat McCrory and the legislature to reconsider their opposition to Medicaid expansion under Obamacare. “Medicaid expansion is a smart choice for states,” White House Spokesman Josh Earnest said during a telephone news conference along with Durham Democrats, Mayor Bill Bell and state Sen. Floyd McKissick.  Earnest said that states would save money “over and above the expense of expanding Medicaid.”  Bell said that in Durham, the state’s fourth largest city, 61,000 people would get insurance if the expansion went through. LINK

Deseret News: My view: Utah needs to expand Medicaid Sarah and Valerie are two next-door neighbors. They share a lot, go to the same church, watch each other’s kids — two apiece — and the families often have barbecues together — there’s no fence between their yards. Their children play together and go to the same school. Both families are considered middle-income and both pay their fair share of taxes. What these two families don't share is similar health care coverage. Neither of the families has health insurance through an employer — Sarah’s husband’s health benefits were dropped by his employer last year. Sarah is a stay-at-home mom, and her husband is a maintenance worker. Their income is $35,000, which is 149 percent of the federal poverty level (FPL) for a family of four in Utah. Sarah’s family purchases health coverage on the new health insurance marketplace. Their annual premium for health insurance, $6,088, is offset by a tax credit of $4,716 under the Affordable Care Act, so their family’s share of the premium is $1,373, a price they can well afford. LINK

Salt Lake Tribune: Utah should expand Medicaid for a lot of reasons Health care reform is a topic that continues to dominate the headlines in Utah and across the U.S. Whether it’s a conversation about the recent government shutdown, signing up for health care insurance through the government website or tuning in to the ongoing debate about whether Utah should expand its Medicaid program — health care is the issue of the day. And it will likely continue on that trajectory in the coming months as Gov. Gary Herbert decides what Utah’s future Medicaid landscape will look like. The governor’s decision is an important one for all Utahns. Why? The Affordable Health Care Act, also known as Obamacare, requires people in the U.S. to get health insurance by 2014 through private insurance from their employer or self-purchased, or through public programs like Medicaid, for those eligible. LINK

NOLA: Be sensible, Gov. Jindal, take the Medicaid money: Editorial Gov. Bobby Jindal's decision to reject the expansion of Medicaid looks worse and worse. A new study by the Commonwealth Fund shows that Louisiana will lose out on $1.65 billion in federal dollars in 2022 alone. The federal government will be paying 90 percent of the cost of the Medicaid expansion that year. If the state agreed to the expansion, its share for the year would be $280 million. The governor has said that Louisiana can't afford even that much. But the co-pay for Medicaid is a small fraction of the $2.2 billion Louisiana is projected to spend on incentives to attract private business in 2022, according the study. And the additional Medicaid money would dwarf the $902 million the state is projected to get in federal transportation funds that year. LINK

Bangor Daily News: Why does the Bangor Chamber of Commerce, like other business groups, support Medicaid expansion? Medicaid expansion was designed to be one of the pillars of the Affordable Care Act. But then the Supreme Court decided that states could decide whether to expand. When states decide against expanding, there’s a big coverage gap, between the lowest income individuals and families who receive Medicaid, and those who can buy insurance through the marketplace and receive subsidies to lower the cost of their premiums. In that coverage gap fall millions of Americans who work for a living but don’t make much money. The politics of Medicaid expansion has been contentious in some states, but business groups are weighing in. Bangor’s Chamber of Commerce is just one of many business groups that want to see an expansion of Medicaid. LINK

Indiana Public Media: Up To 400,000 Hoosiers Fall Into Medicaid Coverage Gap The irony, if you make above the 100 percent of federal poverty then you can buy insurance on the exchanges and get a subsidy to help pay for your premiums but if you fall below 100 percent of poverty then you’re too poor and you don’t get any help at all,” says Dr. Rob Stone, the founder of Hoosiers for a Commonsense Healthcare Plan. As many as 400,000 Hoosiers are in the same boat as Laracuente. How The Healthy Indiana Plan Plays Into Medicaid Expansion The  Affordable Care Act allowed states to expand Medicaid to 138-percent of the poverty level, but Indiana Governor Mike Pence said no.  And he wanted to expand the system using the Health Indiana Plan Model. In August he announced the state had gotten a  waiver from the U.S. Health and Human Services Secretary to continue the program through 2014. But after 2014 it’s up in the air. LINK

Texas Burnt Orange Report: Refusing to Expand Medicaid Will Cost Texas $9 Billion A new study by the Commonwealth Fund, "How States Stand to Gain or Lose Federal Funds by Opting In or Out of the Medicaid Expansion," shows that Texas clearly stands to lose the most of any state. Because of Rick Perry's refusal to expand Medicaid, Texas will forego over $9 billion in federal funds while Perry holds out for a Medicaid block grant that he'll never get.  We've known all along that Texas was walking away from billions of dollars - not to mention the thousands of residents who could have been insured. But this report synthesizes data from a variety of sources to provide new estimates of what exactly the impact on each state would be.  LINK

Herald Sun: Bell, McKissick call for Medicaid expansion Two prominent Durham Democrats joined White House spokesmen on Monday in urging Gov. Pat McCrory and the N.C. General Assembly to reconsider their opposition to expanding Medicaid. “Our residents are really missing out on opportunity here,” Mayor Bill Bell said, adding later that opponents of the expansion may well “see repercussions” at the ballot box in 2014.Sen. Floyd McKissick joined Bell on the White House-organized conference call, and likewise criticized state leaders for rejecting expansion subsidies. He said the decisions will burden small hospitals that cannot afford to offer more care to the indigent. LINK

Sioux Falls Argus Leader: S.D. lawmakers will be urged to expand Medicaid Some lawmakers and health care groups plan to ask the South Dakota Legislature next month to expand the state’s Medicaid program to cover the medical costs of 48,000 more poor people, despite resistance from Gov. Dennis Daugaard. Daugaard last week told state lawmakers he is not recommending the Medicaid expansion, available to states as an option under the federal health care overhaul, as part of next year’s state budget. He said the federal government is having trouble putting the entire overhaul into effect. He also wonders whether the federal government can meet its pledge to pay most of the cost of the expansion. “I have continuing doubts about the federal government’s ability to deliver on its promises,” the Republican governor said. But supporters said an expansion is needed to improve health care for poor people who now wait until they are seriously ill before seeking medical care. They said hospitals are not paid for that emergency care and cover the loss by boosting charges to patients with private insurance. LINK

Dallas FortWorth Healthcare Daily: The Big Money Behind Texas’ Fight Against Medicaid Expansion It’s not news that many conservative Republicans in Texas have lobbied and fought against the expansion of Medicaid in Texas. What is news is the coordinated attack that preceded that fight. New documents—obtained by The Guardian and shared with the Texas Observer—show how the right-wing think tank Texas Public Policy Foundation and another conservative group, the Texas Conservative Coalition Research Institute, combined their attacks with a nationwide network of conservative organizations and funders. The documents contain 40 funding proposals from 34 states; the proposals were to be funded by the Searle Freedom Trust, a private foundation. From the Observer: The documents include a TPPF grant request to Searle to fund continuing attacks on Medicaid. LINK

Wyoming Star Tribune: What‘s your health care solution, Wyo. leaders? Gov. Matt Mead again said no to accepting the Medicaid expansion available from the federal government in his Nov. 29 budget message. And again we say, “Fine, but what’s your solution? The people most interested in the answer could be the more than 16,000 Wyoming residents who do not receive health insurance because the state rejected Medicaid expansion. It was a requirement of the Affordable Care Act until the U.S. Supreme Court ruled that states could choose whether or not to accept expanding coverage. The affected people are those without children earning up to 138 percent of the federal poverty level. Wyoming hospitals also keenly follow the debate. When Wyoming first rejected the Medicaid expansion earlier this year, the Wyoming Hospital Association President Dan Perdue said, “We’re concerned that a lot of people who don’t have insurance will continue to use the emergency rooms for their primary care.” LINK

Cincinnati Enquirer: Medicaid online enrollment begins today in Ohio Ohioans eligible for Medicaid coverage can apply for benefits online starting today at the newly launched web site, benefits.ohio.gov. Online enrollment will be a first for Medicaid in Ohio. Currently, to enroll in the program, a person needs the approval of a caseworker at a county Jobs and Family Services office. Enrollment will be open to an additional 275,000 adults who qualify under Ohio’s expansion of the joint state and federal tax-funded health-insurance program. Ohio’s Medicaid program  covers 2.4 million low-income and disabled Ohioans. Under the Patient Protection and Affordable Care Act, about 600,000 more residents are expected to sign up for coverage by July 1, 2015. About half became eligible in October when Ohio’s Controlling Board voted to accept billions of federal dollars to extend coverage to residents earning up to 138 percent of the federal poverty level, or about bout $15,860 for an individual. LINK

Michigan Daily News: A healthier transition In 2014, the Affordable Care Act will expand Medicaid to cover all adults earning less than 38-percent above the federal poverty level; a large portion of these beneficiaries will be former prison inmates and detainees. Michigan will expand its Medicaid program to help cover the healthcare costs of released offenders and current inmates who require long-term hospitalization or other specialized care outside of prison. This expansion of Medicaid will be financially beneficial to the state. Furthermore, the new benefits available may help former inmates adjust to independent living and could be a way to curb recidivism and improve the lives of former prisoners. LINK

Vanderbilt Research News: Tennessee voters want Medicaid expansion, but many still don’t like ACA, Vanderbilt Poll shows  A substantial majority of Tennessee voters want state lawmakers to accept federal money that has been offered to expand Medicaid, according to the new Vanderbilt Poll.  In a survey taken Nov. 20 to Dec. 5, 2013, of 860 registered voters by landlines and cell phones, 63 percent said they supported the expansion of Medicaid through the Affordable Care Act. Thirty-four percent were against the expansion and 3 percent said they didn’t know. “The decision as to whether the state should expand Medicaid as provided by the Affordable Care Act is obviously an important issue in the state, and the Vanderbilt Poll provides important information about what the public thinks. Hopefully, this will help ensure that the discussion is not just driven by engaged activists on both sides of the issue, as this is not the first time Tennesseans have expressed their approval of Medicaid expansion,” said Josh Clinton, associate professor of political science and co-director of the Center for the Study of Democratic Institutions at Vanderbilt. LINK