Can Peer Pressure Win Over Last GOP Holdouts On Medicaid Expansion?

Wisconsin Gov. Scott Walker, left, listens as Indiana Gov. Mike Pence, right, speaks during a news conference at the Republican Governors Association's quarterly meeting on Wednesday May 21, 2014 in New York. (AP Ph... Wisconsin Gov. Scott Walker, left, listens as Indiana Gov. Mike Pence, right, speaks during a news conference at the Republican Governors Association's quarterly meeting on Wednesday May 21, 2014 in New York. (AP Photo/Bebeto Matthews) MORE LESS
Start your day with TPM.
Sign up for the Morning Memo newsletter

Could peer pressure from other Republicans be the secret ingredient in the Obama administration’s push to get the 20-plus states that have not expanded Medicaid under Obamacare to change their minds?

Health and Human Services Secretary Sylvia Mathews Burwell suggested to TPM on Wednesday that it might be. Some staunch conservatives like Indiana Gov. Mike Pence (above right) have entered into negotiations with HHS to craft their own Medicaid expansion plan; but others like Wisconsin Gov. Scott Walker (above left) have steadfastly refused to even consider it.

Perhaps more than any argument from the Obama White House, the former group could help convince the latter that Medicaid expansion makes sense, Burwell told reporters at a Wednesday briefing in response to a question from TPM.

“People are influenced by people who are like them,” Burwell said. “I think the more that we are able to attract conservative Republican governors, the more that those who have very strong feelings will perhaps listen. They all talk to each other.”

The Obama administration is also putting out new estimates to make the case for Medicaid expansion. HHS is projecting that in 2014, hospitals in states that expanded Medicaid will save up to $4.2 billion on uncompensated care as more people are covered through Obamacare. Hospitals in non-expanding states, by comparison, are saving $1.5 billion.

Medicaid expansion advocates in deep-red states like Wyoming have told TPM that they believe the business case, exemplified by the new data from HHS, is their best shot to convince conservative officials to come around. Wyoming Gov. Matt Mead has met with HHS and pledged to put an expansion plan forward at the beginning of next year. He cited the state hospital association’s statistics on lost money to explain why he was considering it.

The administration is routinely trying to apply public pressure to Republican states to expand Medicaid. The White House has held targeted press calls for states like Florida and Texas. The Council of Economic Advisers released a report in July that outlined the “missed opportunities” for states that have passed up Medicaid expansion.

They have also tried to buttress the “negative form” of the expansion argument with the positive data released Wednesday, Burwell said. In her experience, that economic evidence is usually the most persuasive.

“In terms of the conversations I’ve had, whether it’s conversations with governors or the private sector, you hear the anecdotal evidence of the importance of the reduction in uncompensated care in the hospitals’ bottom lines,” she said. “This is one of the reasons that we see hospitals and others supporting the expansion of Medicaid.”

“The Medicaid issue is retail,” Burwell said later, explaining that HHS’s strategy is to “focus on the (states) that would be most likely” to expand Medicaid.

“We’re now at a phase where we’re actually going to start seeing the benefits, the uncompensated care number,” she said, “and the other benefits states and other governors are articulating to the governors. It’s actually showing that this provides benefits to states.”

Latest DC
Comments
Masthead Masthead
Founder & Editor-in-Chief:
Executive Editor:
Managing Editor:
Associate Editor:
Editor at Large:
General Counsel:
Publisher:
Head of Product:
Director of Technology:
Associate Publisher:
Front End Developer:
Senior Designer: