Posted on 09/04/2018 1:46:23 AM PDT by gattaca
Few states have expanded Medicaid eligibility under the Affordable Care Act (ACA) since 2016, but a new trend may accelerate the pace of adoption. Last year, voters in Maine used their state’s citizen-initiated ballot referendum process to pass Medicaid expansion, and this November, four states will follow Maine’s lead. On Friday, Nebraska’s Secretary of State certified that supporters had collected enough signatures to put the question of Medicaid expansion to voters on Election Day. Nebraska joins Idaho and Utah, both of which will have Medicaid expansion on their November ballots. And late last month, the Secretary of State in Montana announced that an initiative that would permanently reauthorize the state’s Medicaid expansion, which took effect in January 2016 but is scheduled to sunset in 2019, had qualified for the ballot there.
Long Road to Medicaid Expansion More than 50 years ago, Medicaid was created as a jointly funded partnership between the federal government, which establishes parameters, and the states that administer it. While there was a lag between passage of the statute and adoption of the program by all states, the path to Medicaid expansion under the Affordable Care Act (ACA) for individuals with incomes up to 138 percent of the federal poverty level has been far more circuitous.
After Medicaid expansion under the ACA became a state option in 2014, 24 states and the District of Columbia opted for it immediately. By the summer of 2016, seven more states had signed on. Since then, no state has implemented expansion. This pause is likely due, at least in part, to federal efforts throughout 2017 to repeal the ACA, including full repeal of the Medicaid expansion, converting federal funding for the program to block grants, and substantial cuts to federal funding.
Whatever the fate of the ballot initiatives, at least one more state will implement Medicaid expansion next year. This spring, legislators in Virginia voted to expand Medicaid after years of deliberation. Up to 400,000 Virginians are expected to become newly eligible for coverage on January 1, 2019.1 More than a quarter of them are adults who are currently uninsured because they fall into the “coverage gap”: their incomes are too low to qualify for premium assistance in the marketplace, yet they’re ineligible for Virginia’s existing Medicaid program.2
A Good Deal From a fiscal perspective, the case for expansion is compelling for states. After covering 100 percent of the costs of newly eligible Medicaid enrollees through the end of 2016, the federal government currently pays 94 percent of the state costs of Medicaid expansion (dropping to 90 percent in 2020). In 2018 alone, the federal government will provide $59 billion to fund Medicaid coverage for people made eligible for the program under the ACA, according to the latest Congressional Budget Office projection.3
By contrast, the 17 states that have yet to expand Medicaid will leave an estimated $331 billion on the table by 2022, an Urban Institute analysis projected.4 Florida and Texas would each forgo $66 billion in federal support from 2013 to 2022.
One concern voiced by leaders in states that opt not to take up Medicaid expansion is that their state can’t afford their its share of the costs, particularly after the federal matching rate drops to 90 percent. But in each of the four states weighing ballot initiatives, financial impact analyses project that a considerable chunk of the state’s new spending for Medicaid expansion in 2021 and beyond will be offset by savings from other state programs, such as those that currently fund uncompensated care. In Utah and Montana, the initiatives create new sources of revenue projected to further whittle down — and in the case of Utah, completely pay for — the state’s share of expansion costs.
A big thanks to no-name for scuttling Husseincare repeal. s/
Soros funded radicals are ramming this stuff thru a ballot scam .
States will have to stop this new ballot scam the left is using to ram thru
bad ideas .
We’re looking to escape from NYS. Any state that expands Medicaid is getting scratched off our list. And states,if you want to know why, just look at what Medicaid is doing to NYS. Then, if you expand it anyway, God help you because taxpayers don’t have the money.
NYS was that long before Barry came along.
But he corrupted states I never thought would sign up for their own self-destruction.
Sigh.
I thought Medicaid was where citizens had to give up most of what they had to be covered but illegals could go to the hospital at will....
Is that the system where the bill comes due when you die & you will have no estate?
That was the way NY handled it when my Mother needed final care - I forget the paltry amount she was allowed to have as far as assets before they would treat her - and then they did a crappy job.
If the Supreme Court strikes down Obamacare next year then all the federal funding for the Medicaid expansion dies with it. States should probably keep that in mind.
An added ‘benefit’ to expanded Medicaid is the exodus of good doctors from the state, since the reimbursement rates rarely cover their costs.
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