Daley’s View: Are we winning the fight for the expansion of Medicaid?

The Supreme Court ruled that the Medicaid expansion in the ACA would have to be voluntary. The entire future of this expansion seemed to be in doubt. Resource strapped states were fighting to cut programs not to expand them. The entire expansion of Medicaid was challenged by Governors calling for the program to be “block granted,” or they were just flat out saying ‘no’.

The winds are shifting.
What we advocates have done exceptionally well to get people realizing the overwhelming benefit to states in saving benefits, saving lives and saving money. Keep pouring it on, you are winning.

It is clear that advocates around the country have been effective. We have pushed the issue of Medicaid into a debate where politicians staunchly defended Social Security and Medicare, but neglected even to mention Medicaid. Advocates feared that the deficit hawks would be able to force major reductions in Medicaid coverage.

“Weigh the evidence and do the math. With the realities facing us, taking advantage of this federal assistance is the strategic way to reduce Medicaid pressure on the State budget. We can prevent health care expenses from eroding core services such as education and public safety, and improve Arizona’s ability to compete in the years ahead.”


Yep, that’s Arizona Governor Jan Brewer in her State of the State address given in the middle of January.


The Democrats in the evenly divided Virginia Senate vowed to stop the state budget because it did not include the expansion of Medicaid.


There are fights going on in a dozen states over this issue, with politicians being willing to fight for Medicaid.


As the national government reels from one crisis to the next but there seems to be some strengthening of resolve in the Obama Administration on the issue of Medicaid. Last week Gene Sperling, who chairs the National Economic Council and is one of the President’s senior economic advisors told audiences at the Families USA conference that there is no intention on the part of the Administration to support cuts in Medicaid.


This is good news because there have been proposals over the last year that indicated some effort to make changes to Medicaid such as changing the reimbursement rates or capping benefits.


Senate Majority Leader Reid has indicated that the Democrats in the Upper Chamber do not intend to support cuts to Medicaid.


The fight is by no means over. There are dozens of states where governors and legislators have staunchly refused to expand Medicaid. But they too soon will be forced to “do the math.” Surely the tax payers of states like Texas and Louisiana will begin to realize that their tax dollars are pouring into Arizona and, God forbid, California where millions of residents suddenly are being insured. In states that decline federal help, huge incidences of the uninsured will be shifting costs out from the emergency rooms and driving up everyone’s insurance premiums. Dollars that could be converted into jobs in local communities are being spent elsewhere.

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