Medicaid expansion had a good night last night

Medicaid Expansion had a good night last night.

The win by Governor Elect Breshear (D) in Kentucky means that the work requirements that were designed to create significant administrative friction to lower enrollment will be tossed sometime in the first week or two of January. The work requirements were in the form of a waiver application that was powered by an executive order. A new executive order will be sufficient to stop that waiver.

Virginia now has a Blue Trifecta. Work requirements were the cost of going from no-expansion to some expansion in a Republican controlled legislature. That is no longer the case. I could easily see either a significant administrative loosening of exemptions for work requirements or a legislative change that would be signed into law by the governor. I also anticipate Virginia moving off of Healthcare.gov by November 2022 and a reinsurance waiver to be submitted in the next six months.

Now the most interesting and bank shot angle is that the new Mississippi Lieutenant Governor-elect has supported Medicaid Expansion in the past. The new Mississippi governor has not but Mississippi can put an initiative on the ballot. The institutional alignment of power in support of expansion is better today than it was on Monday even if the odds are still fairly low.

Last night changed policy significantly.