For states, rejecting the health law's Medicaid expansion comes with consequences

Apr 23 2013

The Associated Press reports on the wrinkles that state leaders will face as a result of opting against the sweeping expansion. Meanwhile, states and federal officials note possible points where flexibility will be in play. Also, news outlets report on the state-level action regarding this health law provision in Florida, Missouri, South Carolina and Montana.

The Associated Press/Washington Post: State Leaders Deal With Consequences Of Rejecting Medicaid Expansion In Obama Health Overhaul
Rejecting the Medicaid expansion in the federal health care law could have unexpected consequences for states where Republican lawmakers remain steadfastly opposed to what they scorn as "Obamacare." It could mean exposing businesses to Internal Revenue Service penalties and leaving low-income citizens unable to afford coverage even as legal immigrants get financial aid for their premiums. For the poorest people, it could virtually guarantee that they will remain uninsured and dependent on the emergency room at local hospitals that already face federal cutbacks (4/22).

CQ HealthBeat: State Medicaid Officials Consider Multi-Tiered Benefits, Cost Sharing Under Overhaul
The benefits for Medicaid recipients already are different from state to state. And in those states planning to expand the health program for the poor under the health care overhaul, people on Medicaid who live next door to each other could pay different amounts to see a doctor and be entitled to different levels of care (Adams, 4/19).

CQ HealthBeat: Sebelius Promises Flexibility
Health and Human Services Secretary Kathleen Sebelius said in a Jan. 14 letter that states also "may select different plans for different groups of individuals" within the expansion population. One difference between the benefits for the expansion and traditional groups is that the newly eligible are not entitled to nursing home care and other institutional long-term care (Adams, 4/19).

Tampa Bay Times: Moderate House Republicans Key To Any State Health Care Deal
After weeks of posturing and debate, the decision to expand Medicaid in Florida or accept $51 billion in federal health care money might rest with a moderate bloc of a dozen or so House Republicans. And they're not saying a lot, at least publicly. While Senate Republicans appear willing to join Democrats in supporting a massive health care expansion, many House Republicans serving in moderate districts have yet to vocally embrace or reject federal assistance (Mitchell, 4/20).

Health News Florida: House Panel Passes Alternative Health Plan, Rejects Federal Funds
The House Appropriations Committee today passed HB 7169, a measure that creates a program called Florida Health Choices Plus, that will cover about 115,000 people. The committee rejected a strike-all amendment from state Rep. Mia Jones, D-Jacksonville, that would have directed the state Agency for Healthcare Administration to accept federal funds and extend the state Medicaid program under the federal Patient Protection and Affordable Care Act (Watts, 4/19).

The Missoulian: Vote That Killed Medicaid Bill Was A Mistake, Lawmaker Says
A contentious Medicaid proposal to fund private health insurance for thousands of low-income Montanans appears dead at the 2013 Legislature, after House Republicans Friday successfully bottled up the bill in committee. A move by Democrats to bring the measure to the floor failed by a single vote, with one Democrat later admitting he voted the wrong way. A later effort to undo the first vote failed by three votes (Dennison, 4/20).

The Associated Press: Missouri Medicaid Expansion Unlikely In 2013
Proposals to expand Missouri's Medicaid health care program for the poor appear increasingly unlikely to pass during the legislative session that ends May 17. Money for the Medicaid expansion is not included in either the House or Senate version of the state budget. And a Republican alternative to the Medicaid expansion backed by Democratic Gov. Jay Nixon also has stalled. House member Jay Barnes, of Jefferson City, says he has asked the House Rules Committee not to vote on his legislation (4/21).

The Associated Press: Medicaid Agency Posts Hospital Data
Data posted online Thursday for South Carolina's 60 acute-care hospitals shows a wide disparity in their financial health, with the bottom lines of each ranging from a four-year loss of $96 million to a combined profit of $223 million. The state's Medicaid agency put the data on its website in an effort to encourage discussions about an industry at the center of the health care debate, director Tony Keck told The Associated Press before the material was posted. ... Keck said he wanted legislators, business groups and the public to have access to hospitals' financial numbers as the debate over whether to expand Medicaid eligibility under the federal health care law moves to the Senate (4/19).