Medicaid Expansion: What's at Stake for 2014 and Beyond?

By: Joan Henneberry, MS, Principal, Health Management Associates Kathy D. Gifford, JD, Managing Principal, Health Management Associates

The Arkansas legislature’s approval of a private alternative to the ACA Medicaid expansion responds to the concern many states have about growing a public program. Nearly half of state governors are currently leaning against or are undecided on the Medicaid expansion. If these states follow their governors’ pronouncements, an estimated 6.4 million low-income, uninsured adults are at risk of remaining without insurance. Hospitals, employers and the privately insured also stand to lose in states that opt out. In this essay, two former state Medicaid directors examine the Medicaid expansion from different stakeholder perspectives and offer evidence of the sustained financial benefits that can accrue to states accepting federal funding to expand Medicaid eligibility.