In a surprise move, Gov. Jan Brewer, an Arizona Republican, announced in her annual State of the State address this week that she would expand Medicaid as provided for in the Affordable Care Act. It’s a really good decision, because it means some 300,000 Arizonans would get health coverage.
This announcement by Brewer follows on a similar announcement by Gov. Susana Martinez in neighboring New Mexico. Another neighboring governor, Nevada’s Brian Sandoval, took the same stance late last year. Sandoval, not an enthusiastic supporter of the Affordable Care Act, nonetheless decided the Medicaid expansion would be the right thing for his state:
…there was also recognition that it would be unwise to forego an infusion of federal dollars into the state economy. Sandoval’s office estimates that the expansion will enroll 78,000 people and bring more than $700 million federal dollars into the state over the first three years.
“That’s a massive leverage of federal dollars,” said Jeff Mohlenkamp, Sandoval’s budget director. “Considering how many federal dollars we are leveraging, the cost (of expansion) is fairly small.”
Many Republican governors have been less willing to implement Medicaid expansion. A new study shows that Medicaid expansion could actually be a benefit to Ohio’s budget, even as Gov. John Kasich has been unclear about whether he wants his state to take part. Florida Gov. Rick Scott has made frequent claims that expansion would be too expensive for his state, but the numbers he’s been using aren’t accurate—and a top economic adviser told him this weeks ago. Meanwhile, Virginia Gov. Bob McDonnell continues to reject the idea, to the detriment of doctors and hospitals in his state—even as a new study suggests Medicaid expansion could save Virginia $1 billion. And hundreds of thousands of people could wind up uninsured if South Carolina rejects the expansion.
Jesse Cross-Call, a policy analyst at the Center on Budget and Policy Priorities, says that states who reject Medicaid expansion will be putting their citizens at a disadvantage:
Not only is the expansion a good deal for states, but it will benefit their states in other important ways…if Arizona were to forego the influx of federal dollars while continuing to expose its hospitals to rising uncompensated care costs, it could be at an economic disadvantage as compared to its neighbors.
Other governors continue to oppose the Medicaid expansion. But the price of forgoing the expansion — through higher rates of uninsurance, a less healthy workforce, and rising uncompensated care costs — could put them at a competitive disadvantage with states that do expand Medicaid.
The Medicaid expansion is one of the most important parts of the Affordable Care Act—it bring more people into the system, giving them access to cost-effective health care instead of relying on expensive emergency care or forgoing care entirely. It’s a big part of achieving the ultimate purpose of the entire law: making sure everyone, regardless of income, can get their basic health needs met. That’s why we’re paying such close attention to which governors are looking out for their state, and which ones are using their most vulnerable residents as props to score political points. (Looking at you, Rick Perry.)