Medicaid Expansion and the Affordable Care Act

Reply Thu 6 Feb, 2014 01:50 pm
Due to the Supreme Court’s decision on the Affordable Care Act, the decision to expand Medicaid is left up to each state. As of January 2014, twenty-six states and D.C. have accepted to expand Medicaid coverage. Of those twenty-six states accepting, eight have Republican governors (Arizona, Iowa, Michigan, Nevada, New Jersey, North Dakota, Ohio and Utah). All states that have rejected the expansion have Republican governors. What are the benefits of rejecting the Medicaid expansion? Do you think that those that rejected the expansion put their citizens at risk for the sake of political ideals?

The Advisory Board Company. (2014). Where the states stand on medicaid
expansion. Retrieved from http://www.advisory.com/daily-briefing/resources/primers/medicaidmap

Reply Thu 6 Feb, 2014 03:04 pm
@Derek Brockman,
How realistic the reasons being given are I do not know but if my understanding is correct some states are indicating their rejection is based on cost. For example, the expansion as proposed would be 100% funded by the federal government through 2016 but then decrease to 90% after that (Graham & Hall, 2014). In addition to that, the expansion is being referred to as a "high federal match," which indicates the state's already have to have a certain amount of funds committed in order for the federal government to match it. Just as you and I have limited incomes, so do our governments and the only way for governments to get more money, is to take more from the tax-payer. Are those states that reject the expansion putting their citizens at risk for the sake of political ideals - perhaps; perhaps not.

Graham, J. & Hall, L. (2014). Get real on job growth and expand Medicaid. Bangor Daily News. Retrieved from http://bangordailynews.com/2014/02/05/opinion/get-real-on-job-growth-and-expand-medicaid/?ref=OpinionBox
Jack of Hearts
Reply Thu 6 Feb, 2014 06:33 pm
Thank you!

That was the most cogent response I've ever read on able2know - give that man a cookie!
0 Replies
Derek Brockman
Reply Fri 7 Feb, 2014 08:28 am
Thank you for your reply. I am not 100% aware of the in's and out's of how it all works together, so I appreciate the information you give. On the surface ( and this my be my bias showing), I see conservative governors turning down the expansion, and I wonder if they do it because they think it is better for the state or because if they did accept the expansion, it would be career suicide(to be in agreement with the President). It is a tricky question. What do you see as some of the other pitfalls when it comes to the Affordable Care Act?
Reply Fri 7 Feb, 2014 05:22 pm
@Derek Brockman,
nicholeg is correct. The lack of expansion has more to do with the funding of it. To expand Medicaid, the states need to be able to pay for it and many of the states are struggling to be able to do so. In addition, a lot of governors felt it was wrong to put a state run/funded Medicaid expansion into federal legislation. But, there are political reasons for these conservative governors. Typically, Republicans do not want government-run healthcare but want the free market to dictate it. In addition, the idea of entitlement programs does not resonate with the "right". In all, I believe there has to be some collaboration on how to improve healthcare and the ACA is a good start for discussion but not the end of the healthcare debate.
0 Replies
Reply Thu 8 May, 2014 02:18 pm
@Derek Brockman,
Ditto with many of the previous replies. The feds have not really said how long or how much they will fund the new Medicaid enrollees and that does have some state officials concerned. What happens to the state after the feds stop supporting the program? Where does the money come from? Worse yet, what happens to the people who have come to depend on funds from Washington DC to pay for their medicine and care, then the state cannot continue to help?
I also agree that it is a political move.
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Reply Tue 19 Aug, 2014 02:39 pm
the money should come from lotto,afterall the money allocated for the schools seemed to disappear after the lotto gave there percent.the money was suppose to double instead law makers through it into the general fund.where does all the rest of the lotto money go anyway?does the prinapal even get touched??
0 Replies

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