Rising Number of States May Opt Out of Medicaid Expansion

(Newsroom America) -- A number of states are likely to refrain from expanding Medicaid coverage as part of the newly upheld Affordable Care Act, which would mean millions of lower-income Americans would still be left without health insurance.

The New York Times reported Friday that Republican governors in a half-dozen states say they are leery of expanding coverage, even though the federal government is slated to pick up the entire tab of the expansion until 2017 and at least 90 percent of it after that.

Though the U.S. Supreme Court upheld the law's individual mandate requiring most Americans to purchase health insurance, the court did not side with Congress in mandating an expansion of Medicaid so it would cover more people.

When Congress wrote the 2,700-plus page law, supporting members assumed that lower-income people would be able to receive coverage through Medicaid. But those living in states that refuse to expand that coverage may find themselves in a predicament, the Times reported.

That could lead to major battles in statehouses and legislatures in the coming months and years, as lawmakers vie over whether to accept billions more in federal aid to cover the programs.

In states where governors are weighing whether or not to opt out, officials say they are concerned about being able to their share of the Medicaid increases, said the paper. Many are also likely wary of Congress which could, in the future, pass laws forcing states to pay a larger share of the Medicaid tab as part of an effort to trim a federal budget that is trillions of dollars in the red.

Gov. Dave Heineman of Nebraska, a Republican who is also chairman of the National Governors Association, has said he's against expanding Medicaid eligibility.

"As I have said repeatedly, if this unfunded Medicaid expansion is implemented, state aid to education and funding for the University of Nebraska will be cut or taxes will be increased," he said last week.

Added Rob Godfrey, a spokesman for South Carolina Gov. Nikki R. Haley, "We’re not going to shove more South Carolinians into a broken system that further ties our hands when we know the best way to find South Carolina solutions for South Carolina health problems is through the flexibility that block grants provide."

New Hampshire state Rep. Andrew J. Manuse said simply of the expansion, "We can't afford it. It’s as simple as that. Thank God the Supreme Court gave us an option."

GOP Gov. Scott Walker of Wisconsin and Bobby Jindal of Louisiana have said they will wait to see the results of the November elections before they decide to implement Medicaid expansion, in the hope that Mitt Romney and a majority of Republicans will be elected to the White House and Congress respectively, and repeal the law.

"That’s why we have refused to implement the Obamacare health exchange or the Medicaid expansion," Jindal said.

Florida's Republican governor, Rick Scott, has also said his state won't comply with the law for the time being.

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