Harness the power of Medicaid

Seema Verma swearing in
Centers for Medicare & Medicaid Services Administrator Seema Verma is a big advocate for expanding the use of state innovation waivers to reimagine Medicaid. (Office of the Vice President)

Editor's note: This article is part of a multi-page special report, 8 Ways to Fix the Affordable Care Act

By now, a laundry list of studies chronicle all the benefits of expanding Medicaid eligibility under the Affordable Care Act. Thanks to a previous Supreme Court decision, the remaining 19 states aren’t obligated to follow suit, but now that legislative attempts to repeal the ACA have failed, they would be foolish not to.

Not only have Medicaid expansion states experienced bigger drops in their uninsured rates relative to nonexpansion states, but hospitals in these states have also seen lower uncompensated care costs. In addition, low-income people in Medicaid expansion states were more likely than those in nonexpansion states to have a usual source of care and to self-report better health, among other metrics.

Crucially, the Trump administration has even given GOP governors who might be worried about the political fallout a convenient reprieve, as it’s signaled openness to approving waivers that design Medicaid expansion programs with a conservative twist.

RELATED: 5 lesser-known Medicaid changes in Senate healthcare bill

Tom Price speaking
HHS Secretary Tom Price

“Today, we commit to ushering in a new era for the federal and state Medicaid partnership where states have more freedom to design programs that meet the spectrum of diverse needs of their Medicaid population,” Centers for Medicare & Medicaid Services Administrator Seema Verma and Department of Health and Human Services Secretary Tom Price said in a joint statement in March.

In fact, Vice President Mike Pence and Verma both designed such a program in Indiana, which requires beneficiaries to pay a small amount toward their monthly premiums.

RELATED: Healthy Indiana Plan 2.0 neither as bad—nor as good—as some predicted

Other states, meanwhile, have applied for a more controversial Medicaid tweak—enacting work requirements for beneficiaries—and it remains to be seen whether those experiments will be approved and if so, face backlash.

But under the 1332 and 1115 waivers in the ACA, states have plenty of latitude to dream up other ways to better serve Medicaid recipients, such as integrating mental and physical health services for this often challenging population.

Harness the power of Medicaid