Other states, such as Rhode Island, would be barely impacted by the change. There, adults with children are eligible until their incomes are 175 percent over the poverty rate, and children are eligible until their parents’ income reaches 225 percent of the poverty rate - well above the proposed federal limit.
The gang of six is expected to hold a conference call about the Medicaid expansion proposal with a group of governors on Tuesday.
Republicans in the gang of six - Sen. Michael B. Enzi of Wyoming, Sen. Charles E. Grassley of Iowa and Sen. Olympia J. Snowe of Maine - have voiced concern over saddling the cash-strapped states with additional costs.
“Sen. Enzi … believes that approach to covering the uninsured fails on all counts by creating a new, unfunded mandate for state governments, and by putting folks who need health care the most into a federally managed, waste-ridden program already desperately in need of reform,” his spokesman said.
Mr. Baucus has also expressed concern over the impact on state budgets. He insisted Monday that the states would not be left with much to pay for, but declined to reveal specifics of how to avoid the extra costs.
“States, I think, are going to be pleasantly surprised because there are going to be some additional costs, but much less than we originally expected,” he said. “The Medicaid costs with expansion are not going to complicate near as much as we originally feared because of” other programs, such as more generous drug rebates and changes to the state Children’s Health Insurance Program.
The nonpartisan Congressional Budget Office found that the expansion, as described in the House health care bill, would increase federal outlays for Medicaid by $438 billion over a 10-year-period. Mr. Obama said again Monday in a New York speech that he would not sign off on a bill that isn’t fully paid for, a stance shared by Senate Democrats.
Under current law, Medicaid eligibility varies widely by state, with some states providing access to the program at 175 percent of the poverty rate and some offering little more than the federal requirements. States administer the program but are reimbursed by the federal government.