Politics Hold Back Medicaid Expansion in Some Southern States
For
"I can't tell you the number of patients who I see who come in with advanced disease, who have full-time jobs," Givens said. "They haven't seen a physician in years. They can't afford it. They don't have coverage."
This spring, the
Seven of those states are in the South. But as more conservative-leaning states like
Advocates for expanding Medicaid say opposition is largely being driven by political polarization, rather than cost concerns.
Givens, who is also chair of the board of trustees for the
Givens pointed to
In states that have not expanded Medicaid, hundreds of thousands of people fall into the "coverage gap," meaning they earn too much to qualify for Medicaid but are not eligible for subsidies to help pay for private insurance. Those in the coverage gap also can't afford premiums and other out-of-pocket expenses on employer-sponsored insurance even if they are eligible.
The coverage gap is not an issue in states that have expanded Medicaid. In those states, a single person making up to 138% of the poverty level, or about
For the first time in
Had the proposed bills succeeded, some 74,000 Mississippians who are stuck in the coverage gap would have gained access to Medicaid.
White said this year was different because of increased support from the business community.
"I kidded some of my fellow
In neighboring
Ultimately, the
If
"Just the partisan nature of this is definitely a problem," said
"A lot of rural voters are
The main disagreement in the
White said many of his Republican colleagues view extending health coverage through Medicaid as "some form of welfare, some form of giveaway, some form of expanding government."
Opponents of Medicaid expansion in
"If you open up this federal subsidized program for hundreds of thousands of people, then it could actually hurt that labor participation rate, give them another reason not to go to work, to stay at home," said
The federal
This spring,
That's what happened in
However, only about 2,300 people are enrolled — which is fewer than half of 1% of the more than 430,000 uninsured
The state's alternative expansion plan has cost taxpayers at least
As public support for expansion continues to grow in holdout states,
"But it still took a long time," said
Rudowitz said the fiscal incentive under the American Rescue Plan Act played a role in moving the needle in
"Without expansion, there are more people who are uninsured. Hospitals and other providers are not able to get reimbursement because individuals are uninsured," Rudowitz said. "Those are the underlying issues that existed pre-ACA and continue to exist, particularly in states that haven't adopted expansion."
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