Arkansas is one of 30 states that has expanded Medicaid under the Affordable Care Act, and was the first of six states to do so through a federal waiver that created the private option, the program that uses those dollars to purchase private insurance.
What could happen elsewhere in 2016? The National Academy for State Health Policy details how several states that originally declined Medicaid expansion are reconsidering their positions.
“As 2015 comes to a close, Medicaid expansion activity in states has not slowed down. Currently, 30 states and the District of Columbia have expanded Medicaid, and six of these states have chosen to pursue waivers to implement alternative versions of expansion,” NASHP writer Anita Cardwell noted in her story. “As the new year approaches, a number of additional states are considering options for expanding Medicaid—either as outlined by the ACA or through waivers—and other states are planning to propose modifications to their existing expansion models.”
Those include Arkansas’ southern neighbor, Louisiana, where Governor-elect John Bel Edwards, a Democrat, has called expansion one of his highest priorities. Edwards replaced Gov. Bobby Jindal, a Republican and expansion opponent. The Legislature in 2015 passed a financing mechanism to cover the state’s share.
Alabama Gov. Robert Bentley (R) has expressed an interest in expansion, as has South Dakota Gov. Dennis Daugaard (R). Governors in Utah and Wyoming have expressed support, but legislators have voted against those plans, and Utah Gov. Gary Herbert (R) has said any expansion will depend on legislative action.
Meanwhile, in Kentucky, which along with Arkansas has seen the nation’s steepest drop in its uninsured ranks, newly elected Gov. Matt Bevin (R) campaigned saying he would end expansion but since has expressed support for a modification of the program.
Other states, including Arkansas, are seeking to place requirements on recipients such as cost-sharing payments, similar to what Indiana has done.
For another perspective, the New York Times reports on states with Republican governors that have embraced or at least accepted expansion, including Arkansas, while their Republican members of Congress seek to repeal the Affordable Care Act, which created the expansion.