As states are closing out their legislative sessions in the next few weeks, many are addressing whether they will expand Medicaid under the reform law's provision that goes into effect next year.
As of last week, 20 states plus the District of Columbia will expand their Medicaid programs, while 14 states have said they won't. That leaves 16 states that still haven't decided, causing insurers to wonder whether they can reap the benefits of additional new members in states that use managed care to administer Medicaid, reported the Washington Post.
Up for grabs are more than 11 million people who could be eligible for Medicaid benefits if their states expand the program, the Wall Street Journal reported.
Even some Republican governors, like Florida Gov. Rick Scott, who staunchly opposed the Medicaid expansion in the past have changed their minds. However, they haven't all convinced their state legislatures to similarly reconsider their position. "The reaction of some of the Republican state legislators really caught everyone off guard with regard to how strongly they feel," Bob Blendon, a health politics expert at Harvard, told Politico.
What's more, because the reform law doesn't include a firm deadline for states to decide whether they want to participate in the expansion--for which the federal government pays 100 percent of the costs for the first three years--there's no hard and fast timeline for states to adhere to. So insurers may have to continue waiting before they know whether states in which they operate will expand the program.
Here's an update on some undecided states' Medicaid expansion-related activities, as reported by Politico:
- In Montana, Gov. Steve Bullock is considering a special session to decide whether to expand, although some expansion supporters are considering putting the issue on the ballot next year.
- Nebraska Gov. Dave Heineman opposes expansion, but supporters are still trying to pass an expansion bill, despite its suspension in the legislature.
- Utah Gov. Gary Herbert has asked administration officials, lawmakers and stakeholders to consider expansion options, including full expansion and alternatives. The workgroup should issue a report in late summer.
- Oklahoma Gov. Mary Fallin is opposed to expanding Medicaid, but she is awaiting a report from Leavitt Partners that considers alternative options.
- In Michigan, the House removed Gov. Rick Snyder's proposed Medicaid expansion from a budget bill it passed.