Cost deters Medicaid expansion


Medicaid expansion continues to vary in popularity. Twenty-six states and the District of Columbia plan to expand Medicaid, while four are actively considering it and 20 have no plans to do so, reports California Healthline.

So what's keeping states from expanding their Medicaid programs? State leaders and politicians are primarily worried about the cost. For those that plan to expand, the federal government will fund 100 percent of the state's expansion for three years and 90 percent after that. But some states worry the government won't hold up its end of the bargain.

"Many Republicans do not trust the federal government to sustain its increased share of funding for the Medicaid expansion. They argue that paying 10 percent for a program they do not like and that already accounts for a large portion of their budget is still too much," states a recent piece in the Journal of the American Medical Association.

When the U.S. Department of Health and Human Services last year approved Arkansas' plan to use Medicaid funds buy private insurance for consumers eligible for the state-federal health program, the state predicted the cost per person, per month would average $437, according to Forbes. Yet now the monthly cost has reached nearly $496--the state has spent more than $100 million more than it originally intended.

But other industry leaders, including former White House advisor Ezekiel Emanuel, argue the Medicaid expansion deal is "simply too good to pass up," according to California Healthline. Not wanting to pass up the deal, New Hampshire plans to expand its Medicaid program using a private option, FierceHealthPayer previously reported.

Looking ahead, more states could choose to expand. November elections are just around the corner, posing greater potential for leadership changes. What's more, states that chose not to expand will be examining expansion states for signs of cost-effectiveness.

For more:
- here's the California Healthline article
- read the Forbes article
- check out the JAMA piece

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