White House dials up the pressure on Medicaid holdouts

The White House is turning up the heat on Republican governors who have refused to expand Medicaid under ObamaCare, arguing their decision to opt out has harmed their states’ economies.

An analysis released Wednesday by the White House Council of Economic Advisers says the 24 states that refused to cover more people under Medicaid have lost out on nearly $88 billion in federal funding that would have created almost 400,000 new jobs.

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The “evidence is clear that the consequences of states’ decisions are far-reaching, with implications for the health and well-being of their citizens, their economies, and the economy of the nation as a whole,” the report said.

Republican governors and state legislatures have opposed the expansion of Medicaid under ObamaCare, with many fearing the federal government would shoulder less of the cost over time, putting an added strain on state budgets. Governors have also faced pressure from conservatives to stand firm against the healthcare law.

Democrats have seized on the issue to try and go on offense over ObamaCare, which remains unpopular with the majority of the public.

Vulnerable Democrats facing tough reelection races, such as Sens. Mark Begich (Alaska), Mary Landrieu (La.) and Kay Hagan (N.C.), have blasted governors in their states for declining the Medicaid expansion and accused them of denying coverage to “millions of Americans who desperately need it.”

“Your state’s decision not to expand health coverage is creating two Americas: one where millions are benefiting from preventive care and covered treatments while local economies get stronger and healthier by the day; and another where patients continue to show up to emergency rooms without a way to pay,” read a letter sent earlier this month to governors that was signed by 20 Senate Democrats.

Patient advocacy groups, such as the American Cancer Society, are siding with the Obama administration, arguing the Medicaid expansion would provide critical care.

“States are missing a tremendous opportunity to reduce the health and economic burden of chronic diseases such as cancer,” the group said in a statement. “Millions of uninsured people who cannot afford lifesaving cancer screenings or treatments on their own stand to gain affordable health coverage if their state would simply accept available federal funds to improve access to Medicaid.”

The White House report says 1.4 million people would have access to a clinic if all 24 states joined the Medicaid expansion, resulting in an estimated 15.4 million visits to the doctor while reducing the number of people at risk of financial hardship from medical expenses.

“By increasing low‐income individuals’ ability to access care, relieving cash‐strapped families of high out‐of‐pocket costs, and reducing uncompensated care, the expansion in insurance coverage enabled by those federal dollars would boost demand for medical and non‐medical goods and services,” the report says.

The report breaks down the benefits of the Medicaid expansion state by state, using data from the Urban Institute and other sources.

Under the Medicaid expansion in ObamaCare, the government pays the full cost of providing healthcare to people below 133 percent of the federal poverty line for three years. After that, the government will pay 90 percent of the cost, requiring states to pick up the remaining 10 percent.


The Supreme Court gave states the option of rejecting the Medicaid expansion, which Democrats had intended to be mandatory.