Analyzing the Medicaid expansion balance sheet

Dec 13 2012

As states contemplate the financial implications of pursuing the health law's Medicaid expansion, the recent Health and Human Services' decision not to fund partial expansions continues to draw reactions. 

Politico: HHS: No Partial Funding Of Medicaid Expansion
Supporters of the massive Medicaid expansion under health reform cheered HHS's Monday announcement that states have to do all or nothing -; partial expansion isn't an option. But critics said the Republican governors may dig in more, seeing the Department of Health and Human Services offering a dagger, not an olive branch. "Rather than try to engage Republican governors, they decided to ramp up political pressure from provider groups and everyone else and make their lives miserable," said Michael Ramlet, director of health policy at the American Action Forum. "The Obama administration's refusal to grant states more flexibility on Medicaid is as disheartening as it is shortsighted," the new Republican Governors Association Chairman Bobby Jindal of Louisiana said in a statement (Norman and Cheney, 12/12).

Modern Healthcare: Public Hospitals Plan Lobbying Blitz In States Weighing Medicaid Opt-Out
An advocacy group for public hospitals plans to lobby its members to continue explaining to state leaders the importance of Medicaid expansion under the federal healthcare reform law. HHS clarified in a letter issued Monday that it will cover all costs of expanding Medicaid enrollment, as authorized by the Patient Protection and Affordable Care Act, only in states that undertake an expansion of Medicaid eligibility to 133% of the federal poverty level, or as high as 138% of the federal poverty level. Some state political leaders had asked whether they could partially expand eligibility and still receive the federal funding. The National Association of Public Hospitals and Health Systems, representing many of the safety net hospitals facing some of the biggest effects of state decisions on Medicaid expansion, will urge its members to take up the cause of expansion in their states, said Beth Feldpush, the association's vice president for advocacy and policy (Daly, 12/11).

The Associated Press: Sandoval Supports Medicaid Expansion
Gov. Brian Sandoval said Tuesday that he will support expanding Medicaid eligibility in Nevada as called for under the federal health care law to provide coverage for the state's neediest residents. In an exclusive interview, Sandoval said expanding coverage will add 78,000 residents to the state's Medicaid rolls but will save the state $16 million in mental health programs that otherwise would be paid for out of the state general fund (Chereb, 12/11).

The Associated Press: Nebraska To Lose $44M In Medicaid Money
Nebraska will see an estimated $44 million cut in federal Medicaid funding in its next two-year budget, a loss that will force lawmakers to make up the difference with state dollars when they convene next year. The Nebraska Department of Health and Human Services has requested an additional $18.9 million in state aid for fiscal 2014 and $24.8 million in fiscal 2015 to offset the projected loss in federal matching dollars, according to budget documents obtained by the Associated Press (12/11).

The Associated Press: Cost Of Medicaid Expansion Lawmakers' Main Concern
Cost is the primary concern for Mississippi lawmakers faced with a decision on whether to expand the state Medicaid program with the implementation of the Affordable Care Act. The Clarion-Ledger reports that lawmakers discussed the matter on Monday during a joint committee meeting of the Public Health and Welfare and the Insurance committees (12/11).