- Marco Rubio: U.S. at social, moral crossroads
- ‘We’re coming for you, Barack Obama’: Top U.S. official discloses threat from ISIL
- White flags baffle NYPD: ‘We’re lucky it wasn’t a bomb’
- N.Y. Gov. Cuomo’s office interfered with, pressured corruption commission: report
- Brit lawmaker: I would fire on Israel if I lived in Gaza
- VA apologizes to forgotten Marine veteran locked in Fla. clinic, forced to call 911
- U.S. social and economic trends on worrisome track, survey finds
- McDonald nomination unanimously referred to full Senate
- Chuck Norris honorary chairman of NRA voter registration campaign
- GOP outraged Obamacare investigators able to get coverage with fake IDs
Medicaid role fluid in health law
Many governors wary of cost of swelling program rolls
Question of the Day
It’s health care brinksmanship, with hundreds of billions of dollars and the well-being of millions of people at stake.
President Obama’s health care law expands Medicaid, the federal-state health program for low-income people, but cost-wary states must decide whether to take the deal.
Turn it down, and governors risk coming off as callous toward their neediest residents. Not to mention the likely second-guessing for walking away from a pot of federal dollars estimated at nearly $1 trillion nationally over a decade.
If the Obama administration were to compromise, say by sweetening the offer to woo a reluctant state, it would face immediate demands from 49 others for similar deals that could run up the tab by tens of billions of dollars.
As state legislatures look ahead to their 2013 sessions, the calculating and the lobbying have already begun.
Conservative opponents of the health care law are leaning on lawmakers to turn down the Medicaid money. Hospitals, doctors’ groups, advocates for the poor, and some business associations are pressing them to accept it.
“Here’s the big thing: The state does not want to expand Medicaid and get stuck with the bill,” said Dr. Bill Hazel, Virginia’s health secretary. “Our legislators do not like to raise taxes to pay for a benefit someone else has promised. The concerns we have … are around federal solvency and the ability of the federal government to meet its commitment.”
Medicaid covers nearly 60 million low-income and disabled people but differs significantly from state to state. Under the health care law, Medicaid would be expanded on Jan. 1, 2014, to cover people making up to 138 percent of the federal poverty line, or about $15,400 a year for an individual.
About half the 30 million people gaining coverage under the law would do so through Medicaid. Most of the new beneficiaries would be childless adults, but about 2.7 million would be parents with children at home. The federal government would pay the full cost of the first three years of the expansion, gradually phasing down to a 90 percent share.
The Supreme Court said states can turn down the Medicaid expansion. But if a state does so, many of its poorest residents would have no other way to get health insurance. The subsidized private coverage also available under Mr. Obama’s law is only for people making more than the poverty level, $11,170 for an individual. For the poor, Medicaid is the only option.
Although the health care law fully funded the Medicaid expansion and Mr. Obama has protected the program from cuts, the federal government’s unresolved budget struggles don’t give states much confidence.
TWT Video Picks
The subsidies are a hit with patients who don't exist
- Democratic Sen. John Walsh plagiarized War College master's thesis: report
- Obama orders Pentagon advisers to Ukraine
- House task force to recommend National Guard on border, faster deportations
- 'We're coming for you, Barack Obama': Top U.S. official discloses threat from ISIL terrorists
- Hezbollah warring in Syria could join fight against Israel
- Netanyahu's Wikipedia page replaced with giant Palestinian flag
- Hamas orders civilians to die in Israeli airstrikes
- Pro-Russia rebel commander suggests passengers died days before Malaysian flight
- TYRRELL: The birth of a new alignment in the Middle East
- Despite rhetoric, gun prosecutions plummet under Obama
Obama's biggest White House 'fails'
Celebrities turned politicians
Athletes turned actors
20 gadgets that changed the world
Fighting in Iraq