{"id":51402,"date":"2017-11-09T05:38:18","date_gmt":"2017-11-09T05:38:18","guid":{"rendered":"https:\/\/www.biphoo.com\/bipnews\/?p=51402"},"modified":"2017-11-09T05:38:18","modified_gmt":"2017-11-09T05:38:18","slug":"election-results-invigorate-medicaid-expansion-hopes","status":"publish","type":"post","link":"https:\/\/www.biphoo.com\/bipnews\/elections\/election-results-invigorate-medicaid-expansion-hopes.html","title":{"rendered":"Election Results Invigorate Medicaid Expansion Hopes"},"content":{"rendered":"

Election Results Invigorate Medicaid Expansion Hopes<\/span><\/strong><\/span><\/h2>\n

Election Results Invigorate Medicaid Expansion Hopes:- The election results in Maine and Virginia have energized supporters of expanding Medicaid under the Affordable Care Act in several holdout states. After months of battling Republican efforts to repeal the law, they now see political consensus shifting in their direction.<\/span><\/p>\n

Groups in Idaho and Utah are already working through the process of getting Medicaid expansion initiatives on next year\u2019s ballots, hoping to follow Maine\u2019s path after failing through the legislative route. And the outlook for legislative approval has brightened in Virginia after Democrats picked up at least 15 seats in the Republican-controlled House of Delegates and could potentially control the chamber once all the votes are counted.<\/span><\/p>\n

Advocacy groups are also hoping the decisive victory in Maine, and exit polls suggesting health care was the top issue in Virginia, will add momentum to efforts in Kansas and North Carolina.<\/span><\/p>\n

\u201cThe results from Maine and Virginia send a very clear signal that the public is interested in moving past the type of obstruction we\u2019ve seen from policymakers in some states,\u201d said Katherine Howitt, associate director of policy at Community Catalyst, a consumer advocacy group.<\/span><\/p>\n

The expansion debate in many states has been a political stew, with opposition a mix of fiscal concerns, philosophical resistance and stiff political opposition to Obamacare, which made Medicaid expansion possible. But many advocates hope growing public support for expansion and the fading of the Obama era will mean a softening of opposition among some governors and legislators who have long resisted the idea.<\/span><\/p>\n

Expanding Medicaid was a key provision of the Affordable Care Act, meant to ensure that all Americans below or somewhat above the federal poverty line would qualify for government health insurance. But a Supreme Court decision in 2012 made the choice to expand coverage optional for states. Before Election Day, 31 states and the District of Columbia had chosen to accept federal funding to expand coverage.<\/span><\/p>\n

In Virginia, the outgoing Democratic governor, Terry McAuliffe, tried repeatedly to expand Medicaid, but the majority Republican legislature kept blocking it. Advocates there hope that Democratic gains in the legislature, and perhaps some changes of heart among Republicans worried by the exit polls showing health care to be a top concern, could mean enough votes to approve expansion.<\/span><\/p>\n

In Maine, legislators had voted to expand the program five times, but Gov. Paul LePage, a Republican, vetoed each bill. Though the outcome of the ballot initiative is not subject to a veto, Mr. LePage indicated in a statement Wednesday that his administration will not implement the change unless the legislature identifies funding sources for the state portion of the program\u2019s costs.<\/span><\/p>\n

Expansion supporters insisted the state had no choice but to expand Medicaid, but acknowledged Mr. LePage could make it difficult over the next year, his last in office.<\/span><\/p>\n

\u201cHe could violate the law,\u201d said Robyn Merrill, who helped run the pro-expansion campaign. \u201cBut if the people who are now eligible for coverage are denied it, they will have legal recourse.\u201d<\/span><\/p>\n

Not every state\u2019s voters can count on ballot initiatives as a means of expanding Medicaid. Fewer than half the states in the country allow citizen-driven initiatives, including some of the largest that have declined to expand, like Texas and Georgia.<\/span><\/p>\n

Neither does Kansas, where the Republican-controlled Legislature voted to expand Medicaid earlier this year but failed to override a veto by Gov. Sam Brownback. Mr. Brownback is awaiting confirmation to an ambassador at large position in the Trump administration, but Lt. Gov. Jeff Colyer, a fellow Republican who would replace him, has also indicated he would resist expansion.<\/span><\/p>\n

Still, David Jordan, who leads the Alliance for a Healthy Kansas, an advocacy group, pointed out that if Mr. Colyer becomes governor, he will face re-election a year from now in a state where polls have found resounding support for expanding Medicaid.<\/span><\/p>\n

\u201cYesterday\u2019s results in Virginia and Maine should send a message to him,\u201d Mr. Jordan said. \u201cIt could become really tough to go against this wave.\u201d<\/span><\/p>\n

But for many Republican politicians, the idea of expanding Medicaid remains hard to love. Providing government insurance coverage to poor adults who are not disabled is anathema to many. They view such help as discouraging work, though data suggests most new Medicaid recipients have jobs and states that expanded did not see reductions in employment among low-income people.<\/span><\/p>\n

Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, which oversees the program, told state Medicaid directors on Tuesday that her department would begin approving state plans to condition Medicaid coverage for non-disabled adults on work or volunteer hours.<\/span><\/p>\n

\u201cBelieving that community engagement requirements do not support or promote the objectives of Medicaid is a tragic example of the soft bigotry of low expectations consistently espoused by the prior administration,\u201d Ms. Verma said. \u201cThose days are over.\u201d<\/span><\/p>\n

Several states have asked Ms. Verma\u2019s office for permission to impose work requirements on Medicaid beneficiaries. Matt Salo, the executive director of the National Association of Medicaid Directors, said that he thought work requirements might make expansion more acceptable to some state legislatures, like Florida\u2019s, that have been reluctant in the past. \u201cYou can rebrand that,\u201d he said. \u201cYou can do that very effectively.\u201d<\/span><\/p>\n

The federal government paid the entire cost of expanding Medicaid for the first three years of Obamacare, but that changed this year. States now must pay 5 percent of the new beneficiaries\u2019 medical bills, a proportion that will increase to 10 percent by 2020. So any state that expands now will need to find some funding to pay for its share.<\/span><\/p>\n

States that expanded Medicaid expect to spend $8.5 billion from their own funds on expansion in the 2018 fiscal year, according to the National Association of State Budget Officers.<\/span><\/p>\n

\u201cEvery political decision is about value, and the value is what\u2019s the return for the money,\u201d said Tony Keck, a former director of South Carolina\u2019s Department of Health and Human Services, a state that has not expanded. Mr. Keck, now a hospital executive, said that legislators there thought it was more important to invest in existing populations of Medicaid beneficiaries than to expand the program to cover childless adults.<\/span><\/p>\n

In Utah, a newly formed political committee called Utah Decides Healthcare just concluded seven required public hearings around the state and hopes to soon start gathering the 113,143 signatures needed to get an expansion question on next year\u2019s ballot. The Republican-controlled legislature could interfere if the initiative were to pass, but RyLee Curtis, the campaign manager for the Utah effort, said she doubted it would because Gov. Gary Herbert and the State Senate had tried to expand Medicaid in the past.<\/span><\/p>\n

Jonathan Schleifer, the executive director of the Fairness Project, a left-leaning group founded in California that donated nearly $700,000 to the pro-expansion campaign in Maine, said the group was eager to help the efforts in Utah and Idaho and scout out other states where ballot initiatives might work.<\/span><\/p>\n

\u201cGrassroots groups in other states were waiting to see what happened last night and now they know what\u2019s possible,\u201d said Mr. Schleifer, his voice hoarse from whooping at a victory party in Maine on Tuesday night. \u201cIn the next couple weeks we\u2019ll be able to start talking about what other states have the ability to run these initiatives and the grassroots enthusiasm to do that.\u201d<\/span><\/p>\n

Source:-\u00a0https:\/\/www.nytimes.com\/2017\/11\/08\/health\/medicaid-expansion-states.html<\/span><\/p>\n

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