Posted by 10 February 2017
A major part of the Affordable Care Act, or Obamacare, is expanding the Medicaid program. As Republicans in Congress consider their plans to repeal Obamacare, one Republican governor is asking them to preserve this Medicaid expansion: Governor John Kasich of Ohio.
In mid-January, he urged Congress not to eliminate Medicaid expansion during an Obamacare repeal. Medicaid is the joint state/federal program that provides health care coverage to lower-income individuals. In the traditional Medicaid program, the federal government generally pays 43% of the total cost (rates vary by state). Under Obamacare, states would receive federal funds covering 90% of the cost of expanding coverage to childless, able-bodied adults with incomes up to 133% of the federal poverty level.
According to Gov. Kasich, “Thirty-one states — more than half of them with Republican governors — extended Medicaid coverage. Those that did are experiencing significant positive benefits.”
The majority of people who received coverage under Obamacare have done so through Medicaid. Preserving Medicaid expansion would mean preserving this aspect of Obamacare, which troubles some Republicans in Congress. Senator Rand Paul of Kentucky, who has been pushing Congress to replace Obamacare at the same time it repeals the law, said:
A lot of these people actually qualified for Medicaid already so the interesting thing is they thought they were getting something new and they already qualified. My main point is we have to take care of those who can't take care of themselves. But it should be paid for. If we need to expand Medicaid every state needs to decide how much they're going to raise taxes to pay for Medicaid.
If Congress did not preserve the Medicaid expansion, states would still be free to design their programs to continue covering those eligible under Obamacare. However, states would not receive the 90% federal match, but would instead receive the lower matching rate for the traditional Medicaid program.
Supporters of Medicaid expansion worry about what will happen to enrollees if Congress does not preserve the higher federal matching rate. Those who want to end the expansion point to the long-term budget issues that could result from Medicaid spending.
Do you think that Congress should preserve Medicaid expansion as it debates repealing Obamacare?