Health Care

Obama delivers plea for Medicaid expansion

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President Obama is urging more governors to get on board with a controversial part of ObamaCare that expands Medicaid for millions, stressing that its benefits are “bigger than politics.”

“If your state isn’t one of the 28 that has already expanded Medicaid, I’d urge you to consider it, because our team is prepared to work with you to make it happen,” Obama told a group of state leaders gathered in D.C. for the National Governors Association conference.

{mosads}Obama’s remarks are aimed directly at Republican governors – as well as GOP state legislators – who have blocked or halted expansion efforts in more than two-dozen states.

That includes states, like Virginia, that are run by a Democratic governor and a GOP legislature, as well as states like Florida, in which a GOP-controlled legislature is clashing with its Republican governor over the expansion.

About a half-dozen states are currently negotiating with the Obama administration, with most seeking waivers to put a conservative twist on the traditional version of Medicaid expansion.

States that agree to expand the low-income Medicaid program are reimbursed in full by the federal government for the next two years. But in states where ObamaCare remains a contentious issue, Medicaid expansion has become a litmus test for GOP leaders.

Obama cited Ohio Gov. John Kasich, a Republican, who has said that Medicaid expansion saves lives in his state.

“I want to thank all the governors, Democrats and Republicans, supporters and some opponents of the ACA who have expanded Medicaid to millions of people over the past two years,” he said. “I think there’s a recognition that it makes sense, and it’s bigger than politics.”

The Obama administration is coming off recent victories with Republican Govs. Mike Pence of Indiana and Tom Wolf of Pennsylvania, who both struck deals on expansion plans.

Those moves – both by well-known conservative leaders – are likely to spur more governors to jump on board, one Democratic strategist who has closely followed ObamaCare said.  

“It provides a permission slip for other Republican governors to do it. It takes the political toxicity out of the issue and hopefully provides a guide for other Republicans governors to follow, even if they oppose the law,” Doug Thornell, managing director of the firm SKDKnickerbocker, said in an interview.

But federal health officials also suffered a defeat this month as the Tennessee legislature blocked Republican Gov. Bill Haslam’s expansion plan.

The National Governors Association meeting also featured an appearance from Health and Human Services Secretary Sylvia Mathews Burwell – another face of Medicaid expansion – over the weekend. Her remarks were closed press and a spokeswoman declined to say how much Medicaid was discussed.

The Obama administration is anxious to convince all 50 governors to opt in to Medicaid expansion before leaving office, particularly if followed by a Republican White House. Many healthcare experts are predicting federal health officials will be more willing to compromise on how to expand the program.

“I definitely think 2015 will be the year of the Medicaid waiver,” said Caroline Pearson, vice president of Avalere Health.  “The question is really how much the governors are willing to concede.”

White House spokesman Josh Earnest also urged states “to follow through and actually expand Medicaid” in a briefing last week.

“It certainly would have a very big impact on trying to drive down the uninsured rate,” Earnest said.

This story was updated at 2:38 p.m.

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