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Policy Library

Expand Medicaid So Everyone Has Access To Affordable Health Coverage

The 34 states that have expanded Medicaid since 2014 have shown remarkable public health gains. In the sixteen states that have yet to expand Medicaid, 2.2 million Americans do not have health insurance; an additional 1.5 million Americans could also get better access and quality of care. Growing research shows that expanding Medicaid also generates in-state economic benefits. The Ensuring Access to Health Care Act helps states expand Medicaid while controlling costs.

The National Landscape

Passed in:

Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, West Virginia

Introduced in:

North Carolina

In The News

“Take the state of Montana, which expanded Medicaid in 2016 to more than 90,000 people...The expansion of Medicaid generates a half-billion dollars a year in healthcare spending. Of that, 70%, or $350 million to $400 million, is ‘new money circulating in Montana’s economy.’”
“By treating addiction primarily as a public health issue and bringing treatment into the rest of the health care system through Medicaid, [Virginia] has managed to make buprenorphine, other medications, and treatment in general more accessible to patients.”
“Nationally, more than two million poor uninsured adults fall into the 'coverage gap' that results from state decisions not to expand Medicaid...These individuals would be eligible for Medicaid had their state chosen to expand coverage.”

Partners

  • Health care providers
  • Families
  • People dealing with opioid abuse

Opposition

  • Opponents of Social Security, Medicare and Medicaid
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FAQ

Who will this help?
Medicaid expansion delivers healthcare to Americans who fall into the ‘coverage gap’, with income above current Medicaid eligibility but too low to realistically use the marketplace for insurance coverage. If every state acts, roughly 1.9 million uninsured people will receive health insurance.
Isn’t this too costly?
No. The federal government pays 90% or more of the costs of Medicaid expansion. Medicaid expansion will also benefit your state’s economy by improving health care outcomes, creating jobs in the health care economy, and reducing spending on other programs that are less effective and more costly to the state. For example, Montana’s Bureau of Business and Economic Research estimated that, Medicaid expansion would generate 5,000 new jobs for the state.
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Model Policy

SECTION 1 (TITLE):
This act shall be known as the Ensuring Access to Health Care Act.

SECTION 2 (PURPOSE):
This act expands the availability of Medicaid to all people in STATE with incomes less than or equal to 138% of the federal poverty guidelines.

SECTION 3 (PROVISIONS):

(a) Medicaid Expansion. As of the effective date, the DEPARTMENT, shall provide Medicaid coverage to all people under age 65 who have incomes equal to or less than one hundred thirty-eight percent (138%) of the federal poverty guidelines. The medical assistance provided to persons in this Affordable Care Act expansion group shall consist of the coverage described in 42 30 U.S.C. § 1396a(k)(1).

(b) Appropriation to Pay for Administrative Costs. – There is appropriated from the DEPARTMENT the RELEVANT AMOUNT in recurring funds for the UPCOMING fiscal year for administrative costs associated with the Medicaid expansion required by subsection (B) of this act. These funds shall provide a State match for an ESTIMATED FEDERAL FUNDING AMOUNT in federal funds for the UPCOMING fiscal year, and those federal funds are hereby appropriated to pay administrative costs associated with the Medicaid expansion required by Subsection (B) of this act. If the amount of federal funds available for this purpose exceeds the amounts set forth in this section, then the expenditure of State funds for this purpose shall be reduced by an amount equal to the amount of excess federal funds that are available.

(c) Appropriation to Pay for Medicaid Services Costs. – [The expansion of Medicaid services under this act will affect only half of the UPCOMING fiscal year.] There is appropriated from the General Fund to the STATE HEALTH DEPARTMENT, RELEVANT SUM in recurring funds for the UPCOMING fiscal year as part of the Medicaid rebase. These funds shall provide a State match for an estimated AMOUNT in federal funds in the UPCOMING fiscal year, and those federal funds are hereby appropriated to the RELEVANT DIVISION to pay for Medicaid services.

(d) Reductions to Reflect Savings in Other State Programs. – Because the Medicaid expansion required by this act will generate savings to other State programs that currently serve the population to be included in the Medicaid expansion, the following reductions are made [ ].

  • (1) [Since the expansion of Medicaid services under this act will affect only half of the UPCOMING fiscal year, the appropriation to the RELEVANT STATE HEALTH PROGRAMS are hereby reduced by RELEVANT AMOUNT in recurring funds for the UPCOMING fiscal year.]

(e) This act becomes effective January 1, YEAR.