The Leaflet: Medicaid Expansion Debate Continues

Published February 5, 2015

The Medicaid Expansion Debate Continues

States across the country continue to debate whether to expand their Medicaid programs under the Affordable Care Act (ACA). In recent months, Republican governors in several states have considered new proposals to expand Medicaid programs.  

Idaho Gov. Butch Otter (R) has twice assembled a legislative task force to review options for expanding Medicaid and make recommendations. Utah Gov. Gary Herbert (R) announced plans in December that would use extra Medicaid dollars to help low-income residents buy private health coverage. Additionally, Republican governors in Alabama, North Carolina, and Wyoming, as well as Independent Gov. Bill Walker in Alaska, have said they are open to considering Medicaid expansion.

While some states are attracted to additional federal funding, a large number of states remain wary of expanding a program that is already fiscally unsustainable. Arkansas Gov. Asa Hutchinson (R) announced in January he will create a legislative task force to develop an alternative to the state’s Medicaid expansion, which has created severe budget issues. On February 4, the Tennessee Senate Health and Welfare Committee voted against passing Gov. Haslam’s (R) InsureTennessee plan.

A new study by the Office of Inspector General for the U.S. Department of Health and Human Services found half of all providers listed in Medicaid managed-care plans are unavailable to new Medicaid patients, either because they are not at the listed location or because they are simply not accepting new Medicaid patients. For doctors who are accepting new Medicaid patients, the average wait to get an appointment is two weeks, with a quarter of patients experiencing waits of one month or longer.

States should demand flexibility from the federal government so they are able to innovate their Medicaid systems, because without flexibility from the federal government, states will have little power to decrease costs and offer better care to Medicaid patients.

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The January issue of Health Care News reports the U.S. Department of Health and Human Services has once again lowered its estimates of the number of Americans enrolled in health insurance plans through government exchanges in 2014. In May, HHS touted 8 million enrollees; the current figure is more like 6.7 million.

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