Which holdout state will be next to finally expand Medicaid??
Fri, 02/16/2024 - 2:55pm
As I concluded in the last piece:
I strongly suspect that at least one of the remaining holdout states will join the expansion crowd this year, most likely Georgia, Mississippi or Alabama...but it likely will be some state-specific variant as described above. Stay tuned...
Cut to Daniel Chang & Andy Miller in KFF Health News, Today:
Southern Lawmakers Rethink Long-Standing Opposition to Medicaid Expansion
...But lawmakers in Alabama and some other Southern states are reconsidering their opposition in light of strong public support for Medicaid expansion and pleas from powerful sectors of the health care industry, especially hospitals.
Expansions are under consideration by Republican legislative leaders in Georgia and Mississippi, in addition to Alabama, raising the prospect that more than 600,000 low-income, uninsured people in those three states could gain coverage, according to KFF data.
...In addition to Georgia, state House speakers in Alabama and Mississippi have indicated a new willingness to consider coverage expansion. All three states have experienced a large number of hospital closures, particularly in rural areas.
Medicaid expansion has become “politically safer to consider,” said Frank Knapp, president of South Carolina’s Small Business Chamber of Commerce. In his state, Republican lawmakers are weighing whether to appoint a committee to study expansion.
Well, yes. Now that the "Obama" part of "Obamacare" is no longer a factor, I guess it's easier to finally focus on the "Care" part.
As I noted, however, in all three cases it's pretty likely they'll go with at least a partially privatized version as Arkansas has instead of a "clean" expansion of Medicaid proper:
[Alabama House Speaker] Ledbetter prefers a public-private partnership model, and has looked at Arkansas’ program, which uses federal and state money to pay for commercial insurance plans on the Obamacare marketplace for people who would be eligible for Medicaid under expansion.
In Alabama, lawmakers have introduced a plan that would levy a state tax on gaming revenue and could help fund health insurance coverage for adults with annual incomes up to 138% of the federal poverty level.
...Mississippi’s new House speaker, Jason White, a Republican, has said he wants to protect hospitals and keep residents from seeking regular care through the emergency room. More than 120,000 uninsured people in Mississippi would become newly eligible for Medicaid under expansion, according to KFF data.
...Burns, the Georgia House speaker, has said that he’s open to a proposal for an Arkansas-style plan. Republican Gov. Brian Kemp said he would reserve comment until after the legislative process, according to spokesperson Carter Chapman.
...which, again, would be rather inefficient and far more expensive than simply fully expanding Medicaid itself (not to mention that 80% of Medicaid is already privately administered anyway), but...whatever. As I've said before, if that's what they have to do in order to expand Medicaid without admitting that they're expanding Medicaid, so be it.
Of course, as one Alabama-based advocate put it...
Mississippi better not beat us to expand.
— Jane Adams (@janeadamsid) February 16, 2024
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