Medicaid Expansion

Shout-out to Jody Young for bringing this Florida Politics article by Christine Sexton my way this evening:

A ‘Nixon goes to China’ moment? Conservative Republican pushes for state Medicaid expansion.

• 'These are not handouts. We’re not throwing money down the drain. We are helping our working class Americans get ahead.'

A conservative Florida Republican doctor who has been an ally of Gov. Ron DeSantis and his handling of COVID-19 says it’s time for the state to expand Medicaid despite the long-running opposition of GOP legislators.

...[Rep. Joel] Rudman said the loss of Medicaid coverage for hundreds of thousands of Floridians this year illustrates the need for change. A spreadsheet compiled by House Democrats shows of the 524,076 Floridians who have lost coverage in the last four months, nearly 50% are under the age of 21.

Mississippi is one of the ten states where ACA Medicaid expansion still hasn't gone through a full decade after it could have.

A few years ago, Medicaid expansion in Mississippi looked like it might actually happen: While GOP Governor Tate Reeves and the Republican supermajority-controlled state legislature opposed it, in May 2021 there was a strong grassroots effort to put a statewide initiative on the ballot to push it through regardless, exactly how it happened in other deep red states like Utah, Nebraska, Idaho and South Dakota.

Unfortunately, just a few weeks later, the Mississippi Supreme Court crushed that effort:

Back in March, after years of failed and stalled attempts to get it passed, the North Carolina legislature finally pushed ACA Medicaid expansion over the line to be signed into law by Democratic Governor Roy Cooper.

As for when the program would actually go into effect, however...that's been something of a mystery for awhile now. Apparently the wording of the legislation ties it in with it being included in the general state budget, which wouldn't be voted on or approved for months. As a result, no one seemed to be sure when the healthcare expansion program for up to ~600,000 North Carolina residents will actually launch.

Back in July, the Health & Human Services Dept. took an optimistic stance, preparing for the possibility of the program kicking off starting on October 1st of this year. Unfortunately, that was based on the assumption that the GOP-controlled state legislature would actually pass the general budget required for it to happen by September 1st...which didn't happen.

Yesterday I noted that Idaho, which was the one of the first states to start "redetermining" Medicaid/CHIP enrollees the moment the Medicaid Unwinding process began last spring, has at least completed doing so; in the end, over 121,000 - 145,000 Idahoans got the boot, of which somewhere between 51,000 - 106,000 may still actually be eligible for Medicaid/CHIP coverage due to having their coverage terminated for purely procedural reasons.

Today, there's a consolation prize of sorts; via Your Health idaho:

Special Enrollment Period for the Loss of Medicaid Extended

Idahoans who have lost Medicaid coverage have until Nov 30, 2023, to enroll in health insurance through Your Health Idaho

via Dorothy Mills-Gregg of Inside Health Policy:

While most states are reaching the height of their post-pandemic Medicaid renewals, Idaho is returning to nearly normal redeterminations, closing out the bulk of its pandemic eligibility unwinding after removing more than 121,000 Medicaid and CHIP beneficiaries the state deemed most likely ineligible from the programs in six months.

Hmmm...IHP's estimate is lower than that of KFF's daily tracker, which puts Idaho's total disenrollment number at 145,000 as of today.

Idaho’s Medicaid and Children’s Health Insurance Program enrollment grew by roughly 150,000 people during the pandemic’s continuous coverage requirement, maxing out at about 450,000 beneficiaries. An estimated 42% of the beneficiaries who were disenrolled lost coverage due to procedural or paperwork issues.

Mississippi is one of the ten states where ACA Medicaid expansion still hasn't gone through a full decade after it could have (well...eleven if you include North Carolina, where the Republican-controlled legislature is currently holding it hostage).

A few years ago, Medicaid expansion in Mississippi looked like it might actually happen: While the states GOP Governor and Republican supermajority-controlled state legislature opposed it, in May 2021 there was a strong grassroots effort to put a statewide initiative on the ballot to push it through regardless, exactly how it happened in other deep red states like Utah, Nebraska, Idaho and South Dakota.

Unfortunately, just a few weeks later, the Mississippi Supreme Court crushed that effort:

Back in March, after years of failed and stalled attempts to get it passed, the North Carolina legislature finally pushed ACA Medicaid expansion over the line to be signed into law by Democratic Governor Roy Cooper.

As for when the program would actually go into effect, however...that's been something of a mystery for awhile now. Apparently the wording of the legislation ties it in with it being included in the general state budget, which hasn't happened yet. As a result, no one seems to be sure when the healthcare expansion program for up to ~600,000 North Carolina residents will actually launch.

Back in July, the Health & Human Services Dept. took an optimistic stance, preparing for the possibility of the program kicking off starting on October 1st of this year. Unfortunately, that was based on the assumption that the GOP-controlled state legislature would actually pass the general budget required for it to happen by September 1st.

It's now September 18th. Where do things stand?

Over at Inside Health Policy, Dorothy Mills-Gregg has decided to check in on "Georgia Pathways," the Peach State's new program which partially expands Medicaid to residents earning up to 100% of the Federal Poverty Level (FPL), but with a rather significant string attached: Work reporting requirements:

As noted by Madeline Guth of the Kaiser Family Foundation last year:

...in spite of nearly every state which tried to (or succeeded in) implement Medicaid work requirements having their programs shut down by the courts, one state's work/reporting managed to survive: Georgia. As explained in the Kaiser article:

Back in March, after years of failed and stalled attempts to get it passed, the North Carolina legislature finally pushed ACA Medicaid expansion over the line to be signed into law by Democratic Governor Roy Cooper.

As for when the program would actually go into effect, however...that's been something of a mystery for awhile now. Apparently the wording of the legislation ties it in with it being included in the general state budget, which hasn't happened yet. As a result, no one seems to be sure whether NC Medicaid expansion will kick off in October, November, December or January of next year.

However, the state's Health & Human Services Dept. has decided to take a proactive, optimistic stance:

State Takes Action To Start Medicaid Expansion Oct. 1; Launch depends on General Assembly acting by Sept. 1

During this springs Congressional kabuki theater regarding raising the federal debt ceiling, one of the biggest points of contention was House Republicans insistence on tying work requirements (w/stringent reporting) to Medicaid eligibility.

"Work requirements" is as old a saw for Republican politicians as "selling insurance across state lines," and it's just as ineffective and counterproductive (as well as simply being cruel). This debate has been held numerous times before, and the upside of such requirements has been debunked repeatedly, but here he go again:

As Joan McCarter of Daily Kos put it way back in 2015: