States continue to debate Medicaid expansion

Two states that remain on the fence about whether to expand Medicaid continue to push forward with potential ways to provide insurance coverage to more low-income patients.

Nebraska's unicameral and nonpartisan legislature opposes the expansion but a proposed new bill, known as the Wellness in Nebraska Act, or WIN, would use a mixture of Medicaid dollars and the state health insurance exchange to expand coverage.

WIN would offer Medicaid coverage to all individuals and families earning below 100 percent of the federal poverty level, according to the Associated Press via KearneyHub.comThose earning between 50 percent and 100 percent of the poverty level would pay 2 percent of their incomes for coverage, but the government would waive the requirement if they participate in specific wellness programs. Those earning between 100 percent and 133 percent of the poverty level would obtain coverage in the exchange, with Medicaid dollars covering their co-payments and deductibles. Two percent of their income would go toward premiums.

"The Wellness in Nebraska Act continues to offer important advantages to the state that we've been discussing all along--including saving lives and strengthening economic development," State Sen. Sue Crawford told the Associated Press.

Half of the states have declined to expand Medicaid under the ACA, with some outright refusing to do so. But other states have yet to decide and continue to debate the issue.

In Virginia, where recently elected Gov. Terry McAuliffe is a Democrat but the legislature is controlled by Republicans, the state hospital association outlined the potential financial losses their members will suffer, both in terms of missed Medicaid revenue and the elimination of Disproportionate Share Hospital payments. It has compiled potential financial losses for 107 facilities statewide. "It tells a compelling story," Katharine M. Webb, senior vice president of the Virginia Hospital Association, told the Richmond Times-Dispatch.

Providers, such as Bon Secours Virginia Health System, will face $55.6 million in cuts over the next two years and will miss out on $134.7 million in additional Medicaid revenue, according to the Times-Dispatch. Furthermore, the article said HCA Virginia Health System would sustain a net loss of $13.1 million over the next two years even if the state expanded Medicaid, but would lose $53.3 million without expansion.

To learn more:
- read the Associated Press article
- read the Times-Dispatch article

Related Articles:
Cuts, closures face top hospitals in states that didn't expand Medicaid
A state-by-state look at uninsured rates under healthcare reform
Medicaid spending, enrollment to rise--even in states without expansion
Feds: It's not too late to expand Medicaid
States fear delay in Medicaid expansion will jeopardize millions in federal funds

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