When the Supreme Court upheld President Obama’s health care reform bill, it also altered an Obamacare provision that expands Medicaid so that states could choose to opt out of program expansion without losing federal funds. Now, all eyes are on the states as more and more Republican governors announce they will refuse the Medicaid expansion provided by the Affordable Care Act. GOP governors from six states so far have said that they won’t expand Medicaid: Florida, Mississippi, Texas, Wisconsin, South Carolina and Louisiana.
Despite these governors’ opposition to expanding coverage to an estimated 17 million people through Medicaid, health care providers in several states where governors have opted out still support the expansion. A few of their comments include:
- “We are very much in favor of extending Medicaid programs in South Carolina. […] These people are going to hospitals and getting care without payment. […] It only makes sense that we would support expansion.” — Allan Stalvey, executive vice president of the South Carolina Hospital Association
- “Whether you take the most conservative or the most generous number, a lot of people [would gain from health insurance]. …We know from all of the research that’s available that people are better off with health insurance than without it.” — Bruce Rueben, president of the Florida Hospital Association
- “Without the Medicaid expansion, many will remain uninsured, seeking care in emergency rooms, shifting costs to the privately insured, and increasing uncompensated care to health care providers.” — an official from the Texas Hospital Association
- “We think there are essentially three options [for hospitals in states that refuse]. One is you start cutting back on services. …You find yourself basically putting this in the lap of taxpayers and tacking on the bill for your uninsured to their bills. In the worst circumstance, you simply decide you can’t go on in that situation and close your doors. It’s a pretty grim menu of choices.” — Bruce Siegel, the chief executive of the National Association of Public Hospitals, in an interview with Sarah Kliff
Designed specifically to help the poorest Americans, the expansion of Medicaid would provide insurance coverage to all individuals with incomes up to 133 percent of the poverty line. According to several reports, the expansion would also spur economic activity, increase employment, and save states money. Unfortunately, the states that have so far refused to expand Medicaid are also those with the largest number of uninsured.