After momentum surge, Medicaid expansion may contract

After a resurgence in interest, it's possible that Medicaid expansion efforts across the country may begin to contract, Politico reported.

Back in November, it appeared that the midterm elections had dampened the hopes of Medicaid expansion, with voters in five so-called "non-expansion" states electing Republican governors.

By the end of the year, however, the opposite had happened, as several states started talking about Medicaid expansion, FierceHealthPayer previously reported. The list included traditionally conservative states such as Tennessee, where an advocacy group issued a report suggesting that the Insure Tennessee program would bring the state $1 billion in revenue.

Now the tide seems to be turning back, according to Politico

First, though progress is being made in Alaska, Idaho, North Carolina and Tennessee, expansion talks have stalled in Indiana, Montana, Utah and Wyoming. Dan Crippen, executive director of the National Governors Association, told Politico that states want more flexibility than federal Medicaid authorities appear willing to give them.

For example, some states want work requirements or plan premiums as a condition of Medicaid expansion. A spokeswoman for Indiana Gov. Mike Pence (R) told Politico that the governor won't compromise the principles of his plan, including "personal responsibility and accountability" for would-be Medicaid recipients.

Second, Medicaid expansion plans already in place are now under fire in Arizona, Ohio and Arkansas, which arguably has had more success with Medicaid expansion than any other state. In all three states, midterm elections saw gains for conservative Republicans less supportive of expansion than their predecessors.

Proponents face the challenge of distinguishing between Medicaid expansion and the Affordable Care Act, which is considerably less popular. They also point out that states were slow to adopt the original Medicaid program in the mid-1960s.

For more:
here's the Politico story

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