Congressional Democrats have been adding pressure on states that have not yet expanded Medicaid, the government health insurance plan for poor people.
This coming Tuesday, during a House Energy and Commerce subcommittee hearing, they’ll try to turn the effort up to 11.
At the hearing, Democrats will discuss the Incentivizing Medicaid Expansion Act of 2021, which would allow the federal government to fund at 100% for three years the Medicaid expansion for any state that has not yet expanded it as envisioned by Obamacare. Under Obamacare, states that had not expanded their Medicaid programs by 2014 were not eligible for 100% funding for the first three years. The new bill lets states qualify for full funding at any point in the future.
Twelve states have yet to expand Medicaid: Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin, and Wyoming. Voters in two other states, Missouri and Oklahoma, passed ballot initiatives last year expanding their Medicaid programs, although the legislatures in those states have yet to allocate the funding.
And if carrots don’t do the trick with those 14 states, maybe sticks will.
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The Medicaid Report on Expansion of Access to Coverage for Health Care Act, another bill that will be considered during the hearing, will require states that have not expanded Medicaid to issue a report every year on how many of their residents were uninsured for at least six months. The state must also report how many of those uninsured people would be eligible for coverage under an expanded Medicaid and give a breakdown of hospitals’ uncompensated care costs.
States without the expansions that fail to issue such reports will lose federal funding that helps with administering Medicaid.
The recently passed American Rescue Plan Act also offered more funding to states that have not expanded Medicaid. It increased by 5 percentage points the amount of matching funds that the federal government gives to state Medicaid plans.
Fresh off that victory, liberal healthcare advocates are keen to achieve more.
“We’ve seen from states that have expanded Medicaid tremendous health outcomes that have come from it. It is a real no-brainer,” said Anne Shoup, communications director for the liberal healthcare advocacy group Protect Our Care. “We’ll be keeping our eye on governors that have not yet expanded Medicaid, and we’ll be pressuring them to do so.”
But critics say that expanding Medicaid means expanding costs for taxpayers.
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“Attempting to expand government control over the healthcare system won’t help end the pandemic, but it will wreak havoc on state budgets in the long run,” said Dean Clancy, senior health policy fellow at the free-market group Americans for Prosperity. “States that have not expanded Medicaid should understand that doing so will ultimately saddle taxpayers with enormous costs, force cuts to other critical services, and leave people with fewer choices.”
