Is a state required to expand Medicaid if it sets up an exchange?

[prplhze2000]

Serious question. I'm having a discussion with someone about this. Does the law require the state to expand Medicaid if it operates an exchange? Where does it state that in the ACA?

[Don Corleone]

I think that the SCOTUS made a separate ruling on that. The two are not linked. I think.

[cumbo78]

I have a simple question. If insurance law is enacted on a state by state basis, and citizens of said state can only purchase insurance within the state, what role does the Federal Government have? Its intrastate commerce and unless you believe health insurance is a “right”, why can’t the states, 30 of which have Republican Governors, tell the Feds to take a hike?

[kabar]

No.

[Ingtar]

If a state sets up an exchange, they are buying into all the changes in Medicare. The option given by the SC was to not set up and exchange, or participate fully.

[Tenacious 1]

Its intrastate commerce and unless you believe health insurance is a “right”, why can’t the states, 30 of which have Republican Governors, tell the Feds to take a hike?

I've wondered the same thing. The Fed could withhold DOT funding. Right? That seems to be the old standby.

In reality, especially with the Fed. granting waivers left and right to FOBs (Friends Of Barack), how is the state to know what to set up or who is elligible? What if someone goes to work for a waivered company after originally being enrolled in guvt. exchange? Does IRS or State govern or have jurisdiction over the exchange that the State sets up? They can't expect the State to set up the boondoggle, fund it, then let the IRS manage it, can they?

This would be like making a pilot responsible for the safety of the passengers and plane while being forced to let a 5-year old fly it.

(I haven't finished readying the bill. It's longer than Atlas Shrugged by the way.)

[kabar]

The establishment of the exchanges, whether federal or state, has nothing to do with the expansion of Medicaid. Under Obamacare, the Feds could have linked the payment of Medicaid payments (the Fed pay about half of the costs today and would pay all of the additional costs of Obamacare-related Medicaid payments until 2020.)

SCOTUS ruled that the Feds could not withhold current Medicaid payments if states elected not to expand Medicaid payments to those earning 133% of the poverty level. Hence the feds have no leverage in forcing states to incur these additional costs. Obamacare is expected to add 18 million to the current 70 million who are on Medicaid (includes the CHIPS program)

[Tenacious 1]

Holy Triple Post!!!!

I need a moderator over here. :o)

Clean-up on isle 5!