GOP States Give Up $423 Billion By Rejecting Medicaid Expansion

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The 24 states which refused to expand Medicaid under Obamacare are poised to give up $423.6 billion in federal funds over a decade and keep 6.7 million residents uninsured, according to a new study by the Urban Institute and Robert Wood Johnson Foundation.

“In the 24 states that have not expanded Medicaid, 6.7 million residents are projected to remain uninsured in 2016 as a result. These states are foregoing $423.6 billion in federal Medicaid funds from 2013 to 2022, which will lessen economic activity and job growth,” the authors wrote.

This chart comes via the Urban/RWJF study:

The non-expansion states — which include high-population Texas and Florida — feature Republican governors or legislators (or both) who blocked the federal funds. The expansion, initially required by Obamacare, was made optional by the Supreme Court. It covers residents up to 133 percent of the federal poverty line with a low price for states; Washington pays the full cost for the first three years and 90 percent thereafter.

Since September 2013 the number of uninsured fell by 38 percent in expansion states and just 9 percent in non-expansion states, the study found.

Democrats on the state and federal level widely support expansion; some GOP governors (like New Jersey’s Chris Christie and Arizona’s Jan Brewer) have adopted it. Other Republicans (like Louisiana’s Bobby Jindal and Texas’s Rick Perry) have sided with conservative activists who pushed aggressively to persuade state leaders to reject the Medicaid funds. Elsewhere, such as Virginia and Florida, GOP legislators have blocked their governor’s push to expand Medicaid. States have the option to take up expansion in subsequent years.

The study pointed to other economic costs for non-expansion states, notably the higher cost of uncompensated care for hospitals, who are legally required to provide emergency care for patients whether or not they’re insured.

“Hospitals in these 24 states are also slated to lose a $167.8 billion (31 percent) boost in Medicaid funding,” the authors wrote, “that was originally intended to offset major cuts to their Medicare and Medicaid reimbursement.”

Kaiser Family Foundation has the status of Medicaid expansion in each state.

RWJF – Medicaid Study

ABOUT THE AUTHOR

Sahil Kapur is TPM's senior congressional reporter and Supreme Court correspondent. His articles have been published in the Huffington Post, The Guardian and The New Republic. Email him at sahil@talkingpointsmemo.com and follow him on Twitter at @sahilkapur.
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