Medicaid ruling could give red states bargaining power

The U.S. Supreme Court's decision allowing states to opt out of the Medicaid expansion featured in the Patient Protection and Affordable Care Act could give some of the more conservative parts of the country bargaining power in restructuring their programs, Politico reported.

Louisiana Gov. Bobby Jindal has been wondering aloud whether the high court's decision last week may pave the way for block grant funding for state Medicaid programs, according to Politico--potentially fulfilling the dream of many conservative lawmakers who want to radically remake Medicaid delivery.

"I believe [the feds] can go to the states and negotiate" to convert their Medicaid dollars into unrestricted lump payments "for states that want to do this," Jindal said in a media call, the article noted.

Political leaders in at least three other states--Mississippi, Nebraska, Missouri and Indiana--have suggested they would decline federal funding for Medicaid expansion, even though the federal government would be covering all of the costs during the first three years and 90 percent afterward, the Washington Post reported.

However, the temptation of both the funding and the desire to not appear indifferent to their poorest citizens may nudge those states to the bargaining table, according to the Post.

"The federal government is putting a lot of money on the table," Jennifer Tolbert of the Kaiser Family Foundation told the newspaper. "It may be difficult for states to walk away from that money while simultaneously leaving their lowest income residents uninsured."

For more:
- check out the Politico article
- read the Washington Post article

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