Governors are often more pragmatic than other politicians, having to actually run the state government and consider fiscal realities. Accepting Medicaid expansion is an obvious decision for governors, as long as they consider economic factors rather than Republican ideology, as the federal government picks up most of the cost. The federal government pays 100 percent of the cost of Medicaid expansion for the first three years with this gradually dropping to 90 percent in 2020. In contrast, the federal government pays approximately half the cost of the original Medicaid program,with state governments responsible for the rest.
So far some Republican-run state governments have accepted and others have rejected Medicaid expansion. Additional Republican governors would like to participate in the expanded Medicaid system but this is being blocked by more ideological members of the state legislature. AP reports:
Partisan politics have driven states’ Medicaid decisions ever since the Supreme Court ruled in 2012 that expansion was optional, not mandatory, under the new law. Within months, every Democratic governor agreed to expand Medicaid (although Republican legislatures blocked a few of those efforts).
Only nine states with Republican governors accepted the offer…
The law expanded Medicaid eligibility to adults with annual incomes up to 138 percent of the federal poverty level. That will qualify an individual making less than $16,105, and a family of four earning less than $32,913.
So far, 27 states have agreed to expand Medicaid. But several more, including some with Republican governors, now want in. These governors note that their residents pay the federal taxes that fund expansions, so declining to participate amounts to subsidizing other states without receiving benefits.
Several Republican governors and one independent are meeting Republican legislative resistance to their expansion proposals. Some have tried to woo conservatives by adding “free enterprise” provisions, which require federal approval.
Perhaps the most aggressive GOP governor is Bill Haslam of Tennessee, who won re-election in November. Meeting with newspapers and others, Haslam now says Medicaid expansion is “morally and fiscally the right thing to do.”
The full article also reports on Republican legislatures blocking Medicaid expansion in Wyoming and Alaska, as well as reporting that “Arkansas could become the first state to rescind a decision to expand Medicaid.”
