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Republican Governors Kasich of Ohio and Snyder of Michigan Move Forward to Implement ACA Medicaid Expansion

The group of Republican governors signaling support for expanding Medicaid in their states has grown in recent days. The LA Times reports that Governors John Kasich of Ohio and Rick Snyder of Michigan intend to expand eligibility for the program to 138% of federal poverty in 2014, a central element of the Affordable Care Act (ACA) that the Supreme Court made optional for states in a June 2012 decision. Several other Republican governors have also decided to expand their states’ Medicaid programs, including Jan Brewer of Arizona, Brian Sandoval of Nevada, Susana Martinez of New Mexico, and Jack Dalrymple of North Dakota.

This trend reflects a growing divide among the Republican governors, with 15 standing in firm opposition to the program expansion. Govs. Bobby Jindal of Louisiana and Rick Perry of Texas are two prominent examples of those who have said their states will not take up the option. Several other prominent Republicans have not yet made a decision, including Govs. Chris Christie of  New Jersey and Rick Scott of Florida. The Congressional Budget Office has projected that about 5 million fewer people will be covered under Medicaid as a result of many states opting not to extend eligibility.

Governor Synder cited cost savings from preventing avoidable emergency room visits as a reason for supporting the coverage expansion in Michigan, and Governor Kasich said that it would help Ohio spur job growth and make the state more competitive with others. In fact, political and policy observers have cited a number of reasons for different Republican governors to move forward with implementing this piece of the ACA. One major policy reason is that the expansion is fully funded by the federal government for the first three years and no less than 90% thereafter. From a political perspective, certain states have large Latino populations, which would disproportionately benefit from an expanded Medicaid program, and President Obama won several states in both 2008 and 2012 that currently have Republican governors.

Alan Weil, executive director of the National Academy for State Health Policy, noted, “Over time, the vast majority of states will take advantage of opportunities to expand Medicaid when federal funding is available.” He added, “We know, from when Medicaid started, that it doesn’t happen right away. It’s certainly not going to be all the states in year one. But it’s going to be most of them.”

For the full LA Times article: http://www.latimes.com/health/la-na-medicaid-20130208,0,6884419.story


Prepared by John Connolly (2/8/13)

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