Medicaid Expansion Causing “Red” States to Rethink ACA?

According to a recent report, up to a dozen states, including several led by Republicans, could move forward with plans to expand coverage under Medicaid after the November elections. This follows Pennsylvania and other states that have won Washington’s approval to add commercial innovations to the 50-year-old government program to make it more palatable to conservatives.

President Obama’s original idea of using tax money to expand Medicaid has long been a hot button for Republicans who have long denounced the Patient Protection and Affordable Care Act (ACA) healthcare overhaul.   

However, 2 initiatives have led to a change of opinion for some Republican politicians. Most of the 27 states that are already expanding the Medicaid program have begun to reap billions in federal subsidies for insurers, hospitals, and healthcare providers, putting politicians elsewhere under intense pressure to follow suit.

As demonstrated by Pennsylvania’s deal with Washington, President Obama’s administration has also proved willing to accept tweaks that give the private sector a greater role in providing healthcare and place new responsibilities on beneficiaries.

This has resulted in as many as 9 states in discussion with the administration about potential expansion terms, with the possibility of up to 3 more joining in, depending on the results of the November election. As a result, there could be even more pressure on Republican states that have opted out, providing critical mass for an initiative central to the ACA.

Some states with Republican governors, such as Indiana, are negotiating with Washington for agreements that would appeal to conservative constitutes in their states. Others such as North Carolina, South Dakota, and Wyoming are also exploring their options.

In Florida, Wisconsin, and Maine, the outcome of the November election could bring a shift on Medicaid if Democrats win gubernatorial races there.

Administration officials have said they are committed to working with all states to expand and noted that the number of the uninsured has declined much more in states that have expanded Medicaid coverage.

After a tough start following the launch of Healthcare.gov, research has suggested that more than 10 million people have gained health coverage under the ACA.—Kerri Fitzgerald

Source: Thomson Reuters. 2014; Money talks: Obamacare initiative makes headway in Republican states.