Health & Human Services

Where the Undecided States Stand on Medicaid Expansion

Obamacare sign-up starts less than a month but a few states are still answering a basic question: Are they in, or are they out of the law’s massive expansion of Medicaid?
September 12, 2013

Obamacare sign-up starts less than a month but a few states are still answering a basic question: Are they in, or are they out of the law’s massive expansion of Medicaid?

Legislatures in pivotal swing states like Ohio and Pennsylvania are dusting off their gavels from summer recess and diving back into the high-stakes Medicaid debate over whether to extend health coverage to hundreds of thousands of low-income Americans. Others are looking at ballot measures to spur action because lawmakers won’t convene again until next year.

The prolonged uncertainty stems from the Supreme Court’s 2012 decision to make Medicaid expansion optional for states. Most have decided what to do, generally along predictable partisan lines, but several are stuck.

There’s nothing to keep states from joining the program later, but those that delay will miss out on some of the federal cash. Washington is picking up the full tab for expansion through 2016 and then gradually phasing back to paying 90 percent.

Here’s a look at emerging themes in this unfinished chapter of Obamacare.

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