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You are here: Home / Anderson On Health Insurance / Show Me Medicaid Expansion

Show Me Medicaid Expansion

by David Anderson|  October 1, 202110:41 am| 22 Comments

This post is in: Anderson On Health Insurance

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Today I'm celebrating that 275,000 Missourians can FINALLY gain health coverage through Medicaid!! This @jrosenbaum story features Amanda, a woman who has battled cancer and found out she would be eligible because of @ACSCAN https://t.co/VOYtJAYo9g

— Lucy C. Dagneau (@thelucygoose) October 1, 2021

People in Missouri are now able to receive benefits from the Medicaid Expansion that the ACA authorized and funded for everyone in 2010, the Supreme Court made optional in 2012 and the voters of the state approved in August, 2020 and the state legislature did their best to not fund for most of the next year.

Medicaid has been a critical shock absorber during the pandemic. Recent research in Health Affairs led by Paul Shafer of BU in collaboration with UNC Family Medicine plus myself and several other Duke Margolis colleagues found that Medicaid in North Carolina, another non-expansion state, had significant enrollment gains in socially vulnerable counties during the early stages of the pandemic. We also found that the income eligible channels were the most responsive to COVID pandemic enrollment shocks. We hypothesized that the gains in enrollment would be larger in expansion states than in non-Expansion states as people whose incomes drop below 100% FPL but above the low income limits for adult, non-disabled Medicaid would have flowed into Expansion populations.

Now Missouri has a more seamless health system without large gaps were low or no income adults are stuck without coverage but with health care needs.

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Reader Interactions

22Comments

  1. 1.

    Baud

    October 1, 2021 at 10:44 am

    Good on MO. Now elect Dems so you won’t have to wait so long for the next good thing.

  2. 2.

    Old School

    October 1, 2021 at 10:49 am

    Hooray! How many states are there left to go?

    Edit: 12 to go.  Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Wisconsin, and Wyoming.

  3. 3.

    Baud

    October 1, 2021 at 10:54 am

    @Old School: Texas expanded?

    ETA: You say 12, but you only list 9.

  4. 4.

    Old School

    October 1, 2021 at 10:57 am

    @Baud: Sorry.  Texas has not.  The site listed activity in non-expansion states.

    States who haven’t adopted: WY, SD, WI, KS, TX, TN, MS, AL, GA, SC, NC, and FL.

  5. 5.

    lowtechcyclist

    October 1, 2021 at 11:20 am

    Yay!!!! I knew about the MO referendum, and I also knew the GQP-controlled state govt had been dragging its heels.  So I’m glad to hear it’s really happening.

    So 12 remaining holdouts, of which 8 were involved in that secession incident 160 years ago.

    As Neil Young once sang, “Alabama, you’ve got the rest of the Union to help you along. What’s going wrong?”  Still applicable.

  6. 6.

    Geminid

    October 1, 2021 at 11:30 am

    @Old School: A gerrymander-Republican state legislature kept Virginia from expanding Medicaid for seven years. In 2017, Ralph Northam and Democratic Delegate candidates made expansion a central issue in their campaigns. Northam won by 8 points, and Democrats picked up 14 Delegate seats, going from down 65-35 to a 51-=[ minority. This induced 10 Republican Delegates and 3 Senators to cross the aisle and help put expansion through.

    As of the beginning of the pandemic, 400,000 more Virginians were covered by Medicaid. This was probably the single most consequential legislation the General Assembly has passed in decades.

  7. 7.

    Old School

    October 1, 2021 at 11:43 am

    @Geminid: Yep.  Kansas, North Carolina, and Wisconsin all have Democratic governors that want to expand, but are being blocked by a Republican-controlled legislature.

    Florida should have expansion on the ballot in 2022.

  8. 8.

    Ken

    October 1, 2021 at 11:45 am

    @lowtechcyclist: So 12 remaining holdouts, of which 8 were involved in that secession incident 160 years ago.

    Careful, “secession incident” has now been banned in eight states as part of critical race theory.  “The late unpleasantness” is an acceptable substitute.

  9. 9.

    EmbraceYourInnerCrone

    October 1, 2021 at 11:51 am

    @Baud:  Thank you! I love that some of the same people who scream that President Biden wants “socialism!!!” for the U.S. are the same people that love their Medicare, Medicaid, Social Security, ACA health plan, child tax credits, and when they need it: unemployment, SNAP, disability, etc. It makes me want to throw things some days.

  10. 10.

    eclare

    October 1, 2021 at 12:13 pm

    @Old School:  Tennessee had a Republican governor that wanted to expand years ago.  Overwhelmingly R legislature blocked him every time.

  11. 11.

    VeniceRiley

    October 1, 2021 at 12:23 pm

    Now if they can just add a vaccination requirement to stay on Medicaid.

  12. 12.

    Geminid

    October 1, 2021 at 12:28 pm

     

    @Geminid: Well, the proofreader finally got enough coffee. That is a 51-49 minority in the Virginia General Assembly.

    Several of the Republican Delegates who voted for expansion lost primary challenges the next cycle. And their ringleader, former House Speaker Kirk Cox, came in 4th for Governor in this year’s “Disassembled Convention.” One of the Republican Senators retired. Jill Holtzman Vogel and Emmit Hanger, my State Senator, fended off primary challenges in 2019.

    Holtzman probably paid a political price, though. In spring of 2018, when 5th District Congressman Tom Garrett announced his retirement due to a need to deal with his alcohol problem, Vogel did not even try for the seat. Another time, she would have been a natural fit. But Vogel knew that her vote for expansion was anathema to the radicals who dominate Republican politics in the Central and Southside Virginia 5th District. Ironically, the District Commitee selected a vodka distiller to replace the retiring alcoholic.

    Riggleman in turn was knocked out last year by a Liberty University administrator, in a drive-through convention held at his own Lynchburg megachurch. The bible thumper went on to win election by only 5 points. The VA 5th will be a prime pick up target for Democrats next year.

  13. 13.

    Soprano2

    October 1, 2021 at 12:52 pm

    The MO legislature tried every which way to defy the vote of the people. Our Republican governor was actually onboard, but he was passive about it. Some legislators actually said that because the people in their county voted against it they could say it wouldn’t be funded! Once again it was all about how “those people” in the cities wanted Medicaid expansion so they didn’t want to do it, even though rural hospitals were big advocates for the expansion and a lot of rural people will actually benefit from it. I guarantee you a significant amount of the people signing up for it in rural counties voted against expansion or didn’t vote at all when it was on the ballot.

  14. 14.

    Eunicecycle

    October 1, 2021 at 1:04 pm

    @Ken: How about “War of Northern Aggression” that I see on monuments around the South?

  15. 15.

    gene108

    October 1, 2021 at 1:10 pm

    @Baud:

    Now elect Dems so you won’t have to wait so long for the next good thing.

    I wish politics is that simple now that passing social programs that give millions healthcare, lift them out of poverty, etc. is enough to get their vote.

  16. 16.

    Kent

    October 1, 2021 at 1:11 pm

    When we used to live in Texas my wife who is a physician worked for a large Federally-funded public clinic network in Central Texas.  When she started the job the retirement plan was organized as a profit sharing plan and the clinic network put about $25,000 per year into her retirement account through profit sharing.  This was around 2007 pre-Obamacare.

    By the time we left in 2016 the profit sharing retirement contribution had dwindled to about $3,000 per year and salaries hadn’t gone up much at all.  It was entirely attributable to the fact that Texas had failed to expand Medicaid which forced the clinic to do large amounts of indigent care for free of low income patients who would have been covered by Medicaid expansion in any other civilized state.  Failure to expand Medicaid was costing that clinic system millions of dollars per year in lost revenue.

    Yet EVERY FUCKING ONE of my wife’s white male co-worker doctors remained loyal Republicans.  EVERY DAMN ONE OF THEM.  For seemingly smart people they sure couldn’t put 2 and 2 together.  Voting GOP was personally costing them between $25 and $50k through reduced benefits and lower salaries.   Texas was pretty good to us all in all, but man am I glad we left before Trump.  I don’t I could have taken living through the Trump Admin and Covid in Texas.

  17. 17.

    Geminid

    October 1, 2021 at 1:25 pm

    @gene108: Virginia Democrats were able to Medicaid expansion a winning issue in the 2017 state election. But a sitting Democratic Governor helped rally them in favor of the popular legislation that he fought for.

    Interestingly, Democrats made gun safety a winning issue in 2019. They used to be afraid to touch the issue. But gun safety has become a popular issue in suburban districts that Democrats have been flipping.

    After that election, gun rights advocates rallied their followers, and dozens of rural counties like my own declared themselves “2nd Amendment Sanctuaries.” Over 10,000 gunners converged on Richmond to demonstrate. But when the six gun safety measures passed by Democrats were signed into law last July, I did not hear of any organized protests.

  18. 18.

    Ken

    October 1, 2021 at 1:27 pm

    @Eunicecycle: “War of Northern Aggression” is acceptable because no-one will be upset by it. Well, northerners, and people opposed to slavery, maybe; but they don’t count.

  19. 19.

    Ken

    October 1, 2021 at 1:28 pm

    @VeniceRiley: Now if they can just add a vaccination requirement to stay on Medicaid.

    It’s Missouri, so they’re more likely to add a requirement that you run a puppy mill or hold dogfights.

  20. 20.

    James E Powell

    October 1, 2021 at 2:06 pm

    @Old School: 

    It’s evidence that Republicans are pro-suffering.

  21. 21.

    Geminid

    October 1, 2021 at 2:36 pm

    @James E Powell: They are also trapped by ideology and tribalism. In Virginia Medicaid expansion was cursed a Obamacare, and the business community that used to call the shots in the party could not rally Republicans around such an obviously practical program. A lot of the Virginia Democratic party’s recent success is due to demographic change, but a lot also is the result of Republican pigheadedness.

  22. 22.

    rikyrah

    October 1, 2021 at 5:00 pm

    Happy for my fellow citizens

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