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Medicaid expansion roundup: Waiver programs gain steam in GOP states


In the wake of the King v. Burwell ruling to uphold federal health insurance subsidies, advocates continue to push for Medicaid expansion in some of the most unlikely of states.

President Barack Obama said last month that his focus will now turn to convincing governors to expand the program. Some states have in fact made moves to do so, many of them embracing the idea of waivers instead of full Medicaid expansion. Here's a look at some of the latest developments:


Officials in the Southern state are considering a proposal from Grady Health System in Atlanta that would extend coverage to uninsured individuals through a Medicaid waiver program, Georgia Health News reports. The program is modeled after the Cleveland MetroHealth Care Plus, which is featured in a recent study published in the journal Health Affairs that cites its ability to improve health measures and lower costs among the Medicaid population.

The Atlanta health system's proposal involves using federal matching Medicaid dollars to set up pilot sites to cover the uninsured and manage their care.


The Lone Star State seems one of the most unlikely to expand the Medicaid, even though it may forgo about $100 billion in federal funding over the next decade in doing so. Nevertheless, advocacy groups launched a petition campaign and plan to testify at public meetings to spur Texas to follow other conservative states' lead and embrace a Medicaid waiver plan, Anne Dunkelberg, associate director of Center for Public Policy Priorities, told the Texas News Service.

Such a plan "will bring in between $6 billion and $10 billion a year for Texas in new federal healthcare spending and create somewhere between 200,000 and 300,000 jobs," she added.


This state's Medicaid expansion alternative plan may raise a red flag with the Centers for Medicare & Medicaid Services, given that it requires beneficiaries to contribute as much as 2 percent of their income in monthly premiums.

The state has given the public 60 days to comment on the plan, hoping it can finalize it in time for open enrollment in November.


The Hoosier State has a similar Medicaid alternative plan to Montana's, in that it requires eligible residents to contribute monthly premiums from $1 to $27 into a special health account. More than 297,000 individuals had enrolled in Indiana's program as of July 1, nearly three-quarters of whom were making the required contributions to the state.

Cost-sharing plans like those in Indiana and Montana may be cost-prohibitive for Medicaid enrollees, past research has shown, though the Obama administration has indicated it is open to talking to GOP governors about such proposals, FierceHealthPayer has reported.

To learn more:
- read the Georgia Health News report
- here's the Health Affairs study (subscription required)
- check out the Texas News Service article

Related Articles:
Montana's Medicaid proposal may face scrutiny from CMS
Indiana's Medicaid program paves way for other states
Republican AGs: CMS must stop 'coercive efforts' to expand Medicaid
Focus turns to Medicaid expansion in wake of King v. Burwell ruling