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15-07-2012 | Article

US Governors vacillate on Medicaid expansion

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MedWire News: Although the US Government would pick up the tab for nearly all of the expansion of Medicaid planned under the Patient Protection and Affordable Care Act (PPACA), several state Governors appear reluctant to take advantage of the largesse.

Many Republican and some Democratic Governors appear to be on the fence about providing coverage to millions more poor and low-income residents through expansion of Medicaid, a federal program administered through each state, The Washington Post reports.

Montana Governor Brian Schweitzer, a Democrat, told The Post that although the federal Government would foot most of the bill for extending Medicaid coverage to 84,000 Montanans, an increase of 54.5% in the state's Medicaid rolls, he is concerned that the state would have to go into hock to meet its obligations.

Montana officials estimate that the state would be responsible for an additional $ 71 million by the year 2019, but according to the non-profit Kaiser Family Foundation, Montana's additional contribution by 2019 would be only half that amount, approximately $ 34 million.

Part of the uncertainty stems from the US Supreme Court's landmark decision upholding the legality of the PPACA. Although the court upheld the law's provisions governing the expansion of Medicaid, it added that neither the legislative nor executive branches of Government have the power to punish states that do not comply with the law by withholding all Medicaid funding.

The Justices did rule, however, that the federal Government may withhold new Medicaid funds from states that are not in compliance with the law when it is fully enacted in 2014.

The National Governors Association, Republican Governors Association, and the National Association of Medicaid Directors sent a letter to Secretary of Health and Human Services Kathleen Sebelius asking for clarification about state obligations under the PPACA, the article notes.

It is likely that despite their objections to implementing the law, many states will ultimately decide to accept the federal funds, because failure to do so would place a financial strain on state resources.

In her reply to the Governors, Sebelius wrote: "I am hopeful that state leaders will take advantage of the opportunity provided to insure their poorest working families with the unusually generous federal resources while dramatically reducing the burden of uncompensated care on their hospitals and other health care providers."

By Neil Osterweil