© Provided by Washington Examiner For states that have not yet expanded Medicaid, the Democratic $1.9 trillion spending bill set for House passage Wednesday contains a sweetener. It will boost the amount the federal government supplies to state Medicaid programs by 5 percentage points for two years.
Under Medicaid, the government healthcare program for the poor, costs are shared by federal and state governments. The amount that the federal government pays is called the Federal Medical Assistance Percentage. FMAP is determined by a state's per capita income. Thus, poorer states tend to receive large FMAPs. For example, Mississippi, the poorest state in the country., receives an FMAP of 84%. Wealthier Connecticut has one of about 56%.
RURAL HOSPITALS ARE ON THE BRINK OF COLLAPSE
Mississippi, which has not yet expanded Medicaid, would see its FMAP rise to 89% under the bill were it to expand the program. The increase only applies to states that have not yet expanded Medicaid. Connecticut, which expanded its program in 2014, would not be eligible for the FMAP increase.
When passed into law in 2010, the Affordable Care Act, also known as Obamacare, required states to expand their Medicaid programs to all people up to 138% of the federal poverty level. The federal government pays 90% of the cost of the expansion.
However, in the 2012 case National Federation of Independent Business v. Sebelius, the Supreme Court ruled that the federal government could not force states to expand Medicaid. Rather, states could voluntarily opt in.
Twenty-nine states and the District of Columbia had expanded their Medicaid programs by 2015. Today, only 12 states have yet to expand Medicaid: Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin, and Wyoming.
Whether the FMAP increase will entice any of those states to expand Medicaid remains to be seen. The Congressional Budget Office expects that some states will. Rather than say which states would expand Medicaid, the CBO assumed in its analysis of the Democratic bill that Medicaid would cover 70% of eligible adults nationwide by 2030, up from about 60% at present. The CBO estimates that it would cost the federal government $15.5 billion from 2021-2030.
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In 2020, voters in Missouri and Oklahoma approved ballot measures to expand their Medicaid programs. However, legislatures in both states must figure out how to fund the expansion. Because neither has yet done that, both states could qualify for the FMAP increase.
Tags: Healthcare, Coronavirus, Medicaid, Medicaid Expansion, CBO, Mississippi, Connecticut, Affordable care Act, Obamacare
Original Author: David Hogberg
Original Location: Democratic $1.9 trillion spending bill pressures states to expand Medicaid