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More than Halfway There: New Opportunities to Expand Medicaid and Level the Playing Field

With Louisiana’s decision, over half of the uninsured Americans who could gain coverage from expanding Medicaid will be able to do so.

In his final State of the Union Address on Tuesday night, President Obama focused on America’s future and discussed the building blocks necessary to give everyone a fair shot at opportunity and security in our nation’s new economy. To build on our progress in the coming year and beyond, we need to finish the job of making sure all Americans have affordable health coverage and health care.

Along with other key provisions of the Affordable Care Act (ACA), Medicaid expansion is part of the reason why, for the first time ever, more than 90 percent of Americans are insured and have the financial security and peace of mind that comes from being able to access quality, affordable health care when you need it. The ACA provides the opportunity and resources for states to extend coverage to all non-elderly adults with income below 133 percent of the Federal poverty level (currently $32,253 for a family of four). By the end of 2015, 30 states and the District of Columbia had expanded their Medicaid programs. And so far this year, Governors in South Dakota, Virginia, and Wyoming are including this option in their budget submissions.

Just this week, Louisiana Governor John Bel Edwards took swift action to give hundreds of thousands more low-income Louisianans access to Medicaid coverage starting on July 1, 2016. This additional coverage will result in an estimated 22,000 more people receiving all needed care each year, 230 fewer deaths a year, and 27,400 fewer people having trouble paying their bills because of medical expenses. It will also have significant economic benefits for the state, including an estimated $200 million reduction in uncompensated care costs.

Expanding Medicaid in Louisiana will have national significance as well. With Louisiana becoming the 31st state, plus the District of Columbia, to expand Medicaid, more than 50 percent of those estimated to gain coverage from Medicaid expansion live in states that have done so – 4.4 million people.

As this progress shows, state officials across the nation know that Medicaid expansion is a great deal for their states – a win for both the health of their residents and the vibrancy of their economies. In fact, a recent study comparing two states that expanded Medicaid to one that did not found that the expansion states saw an increase in residents with chronic conditions getting regular medical care, and a decrease in residents skipping medications because of cost or having trouble paying medical bills. In the 19 states that have yet to expand Medicaid, more than 4 million people could gain coverage, states could realize major savings in other parts of their budgets, and over $4 billion in uncompensated care costs could be avoided. And with expansion comes sustained Federal support: the Federal government covers 100 percent of the costs of newly eligible individuals’ coverage through calendar year 2016, phasing down to 90 percent in 2020 and beyond.

To help finish the job and seize these benefits in the years ahead, President Obama is proposing an extra incentive to states that have not yet expanded their Medicaid programs. Specifically, his Fiscal Year 2017 Budget will include a legislative proposal to provide any state that takes up the Medicaid option the same three years of full Federal support and gradual phase down that those states that expanded in 2014 received, no matter when the state takes up the option. This common-sense proposal makes the expansion as good a deal for states that expand now as it is for the states that have already done so. It is further evidence of the Administration’s willingness to work with states to build on recent progress in improving health coverage and making Medicaid affordable to states and taxpayers alike. We hope Congress will act to provide this extra incentive to states that haven’t yet expanded, encouraging them not to miss out on the benefits other states are already enjoying.

Our progress on Medicaid expansion is real and meaningful, and more work needs to be done for those who fall into the expansion gap. Medicaid expansion is working for Americans across this nation, but the job isn't over so long as families and workers in 19 states can't access affordable health insurance. State officials in Alabama, Florida, Georgia, Idaho, Kansas, Maine, Mississippi, Missouri, Nebraska, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin and Wyoming should expand Medicaid as soon as possible to help their citizens and their economies.