Up to a dozen states, including several led by Republicans, could move forward with plans to increase coverage under the New Medicaid Expansion Program under the Affordable care Act – but after the November elections.
Republican leaders have portrayed the whole health care reform effort as a form of socialism encroaching on American values.
A funny thing has happened on the way to the forum: The 26 states that are already expanding the Medicaid program have begun to realize billions in federal subsidies for hospitals and health care providers, putting the non-Medicaid expansion states under pressure to opt in to the new initiative. The new federal funds are helping statewide economies – many with stagnant tax revenue and finances thanks to the Great Recession. They now see those new Medicaid funds as a budget surpluser, job creator, tax reducer and making a whole bunch of citizens (I mean voters) happy.
Moreover, the recent Medicaid arrangement between the White House and Pennsylvania shows conservatives that the private sector can be part of the new Medicaid Expansion equation a la similar arrangements in Arkansas and Iowa, and place new responsibilities on beneficiaries (the skin-in-the-game tactic, although it is tough to insist that poor beneficiaries who cannot afford health insurance in the first place to pony up co-insurance and co-pays. I thought the whole idea was to facilitate access to timely care when people are sick and not erect payment obstacles).
Let’s face it; many states that are not participating in the new Medicaid expansion continue on this path, they will be marginalized to a significant degree on many fronts, and especially to the considerable detriment of their citizens. So Mr. Governor and Fearless State Leaders: Just take the money and run and don’t worry about philosophy and focus on addressing two major state problems – rising numbers of uninsured people and a poorer state economy compared to the one next door that is expanding Medicaid.
If you are a health care enterprise, where would you expand your operations – in the state that is expanding health insurance coverage or the one that is not?
Competition cuts many ways.