Pressure is building on some of the remaining 20 states that have yet to take advantage of federal dollars available to expand Medicaid programs for poor Americans under the Affordable Care Act.
The federal government traditionally picked up a little more than half the cost of Medicaid. But funding under the health law is unlike past efforts to expand Medicaid in that the federal government will pick up the full tab though next year. The state gradually has to pick up some costs in 2017, but by 2020, the federal government is still picking up 90% or more of Medicaid.
With a year to go to get 100% of the dollars available from the federal government, four states including Wyoming and South Dakota are discussing adoption of the Medicaid expansion, according to the latest tally from the Kaiser Family Foundation. Already 31 states including the District of Columbia have adopted the Medicaid expansion, and Hillary Clinton last night during the Democratic presidential debate said states not expanding are shifting costs to Americans with coverage.
A snapshot of the pressure on the 20 states still opposed to Medicaid expansion can be seen this month in Kansas where GOP lawmakers and Republican Governor Sam Brownback have faced an onslaught of lobbying from hospitals in the state, advocates for the uninsured, media and Kathleen Sebelius, Kansas’ former Democratic governor and the U.S. Secretary of Health and Human Services in President Obama’s first term.
“Accepting Medicaid expansion...will not cost the state a dime and actually could save money that is currently spent on specific healthcare programs in Kansas,” the Hutchinson (Kan.) News editorial board wrote this week in an editorial, citing a report funded by a half dozen healthcare foundations.
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Though the report outlined costs to cover 180,000 Kansans with Medicaid coverage, it said savings would surpass $117 million.
“The savings would come largely from programs currently financed by Kansas taxpayers, such as mental health and substance abuse treatment, inmate healthcare, and a reduction in uncompensated care at rural clinics and hospitals,” the Hutchinson News editorial said. “Now we have evidence that, contrary to the partisan talking points, accepting the Medicaid expansion would save Kansas taxpayers money while also providing tangible benefits for the state’s businesses and its workers.”
To get Kansas and other remaining states, the Obama administration has eased past opposition to requiring Medicaid recipients to share in costs through co-payments or paying a portion of the premium.
In Montana, for example, the state got a waiver from the Obama administration requiring Medicaid beneficiaries to pay premiums and co-pays.
