The Washington Post

Four states maneuver on Medicaid expansion


Georgia Gov. Nathan Deal (R), right, isn’t about to expand Medicaid (Erik S. Lesser/ European Pressphoto Agency)

Faced with the prospect of tens of millions, if not hundreds of millions, in federal funding, states are racing to find politically palatable ways to expand Medicaid. Here are the four states moving this week toward — or in one case away from — expanding Medicaid to cover those earning up to 138 percent of the federal poverty line:

South Dakota: Officials have begun negotiating with the Department of Health and Human Services to find flexibility in expanding coverage. HHS officials have started asking questions of their South Dakota counterparts, in part at the urging of state legislative Democrats, who want to give Gov. Dennis Daugaard (R) the political cover he needs to accept the federal funding.

Daugaard has asked if his state could expand Medicaid to cover those who make up to 100 percent of the poverty limit, $11,670 for an individual and $23,850 for a family of four. Those who make between 100 percent and 138 percent of the federal poverty limit would receive subsidies to pay for private insurance through the federal health-care exchange.

Time is running out, though: The South Dakota legislature is only in session for another two weeks. Even if HHS and South Dakota come to an agreement in principle, the waiver process would take weeks to complete. Daugaard said last week he has the unilateral authority to expand Medicaid, although he said he would consult with legislative leaders before taking action.

New Hampshire: A bipartisan proposal dubbed the “New Hampshire Health Protection Program,” one of several programs that would expand coverage through what proponents call the “private option,” is gaining support in the legislature while activist Republicans move to block it. State Senate Majority Leader Jeb Bradley (R) defended the bill before the Merrimack County Republican Party, which promptly voted to oppose the legislation.

The bill, a compromise struck between Republicans and Gov. Maggie Hassan (D), is expected to pass the Republican-controlled Senate, the Union Leader’s John DiStaso reports. It will likely sail through the Democratic-led House.

Maine: Two Republican lawmakers have proposed expanding the state’s Medicaid program to cover about 60,000 additional low-income residents and create a managed care system for all Medicaid recipients. The managed care system would help reduce costs, an element designed to attract Republican votes.

But the bill’s future is uncertain. It passed the legislature’s Health and Human Services Committee on a party-line 7 to 5 vote Monday, although opposition from several key Republicans has Democrats worried they won’t have the votes to override Gov. Paul LePage’s (R) expected veto. Democrats fell three votes short of overriding a veto last year.

LePage’s administration is campaigning against the expansion.

Georgia: Republicans in the state legislature don’t want Gov. Nathan Deal (R) to take Medicaid expansion into his own hands. The state House on Monday voted to strip Deal of the power to expand Medicaid unilaterally, on a party-line vote.

Deal had already ruled out expanding Medicaid. The legislation, though, would mean that if Deal is upset this year by state Sen. Jason Carter (D), the Democrat wouldn’t be able to broaden the program later.

The bill now heads to the Senate.

Reid Wilson covers national politics and Congress for The Washington Post. He is the author of Read In, The Post’s morning tip sheet on politics.

The Freddie Gray case

Please provide a valid email address.

You’re all set!

Campaign 2016 Email Updates

Please provide a valid email address.

You’re all set!

Get Zika news by email

Please provide a valid email address.

You’re all set!
Comments
Show Comments
The South Carolina GOP primary and the Nevada Democratic caucuses are next on Feb. 20. Get caught up on the race.
Past South Carolina GOP primary winners
South Carolina polling averages
Donald Trump leads in the first state in the South to vote, where he faces rivals Ted Cruz and Marco Rubio.
South Carolina polling averages
The S.C. Democratic primary is Feb. 27. Clinton has a significant lead in the state, whose primary falls one week after the party's Nevada caucuses.
62% 33%
Quoted
We'll have half a million voters in South Carolina. I can shake a lot of hands, but I can't shake that many.
Sen. Marco Rubio, speaking to a group of reporters about his strategy to regain support after a poor performance in the last debate
Fact Checker
Sanders’s claim that Clinton objected to meeting with ‘our enemies’
Sanders said that Clinton was critical of Obama in 2008 for suggesting meeting with Iran. In fact, Clinton and Obama differed over whether to set preconditions, not about meeting with enemies. Once in office, Obama followed the course suggested by Clinton, abandoning an earlier position as unrealistic.
Pinocchio Pinocchio Pinocchio
The complicated upcoming voting schedule
Feb. 20

Democrats caucus in Nevada; Republicans hold a primary in South Carolina.

Feb. 23

Republicans caucus in Nevada.

Feb. 27

Democrats hold a primary in South Carolina.

Upcoming debates
Feb 13: GOP debate

on CBS News, in South Carolina

Feb. 25: GOP debate

on CNN, in Houston, Texas

March 3: GOP debate

on Fox News, in Detroit, Mich.

Campaign 2016
Where the race stands

To keep reading, please enter your email address.

You’ll also receive from The Washington Post:
  • A free 6-week digital subscription
  • Our daily newsletter in your inbox

Please enter a valid email address

I have read and agree to the Terms of Service and Privacy Policy.

Please indicate agreement.

Thank you.

Check your inbox. We’ve sent an email explaining how to set up an account and activate your free digital subscription.