June 12, 2014: I am distressed that more states did not demand more flexibility with this program in exchange for expanding Medicaid. Half of the states have decided to expand it; half have not after the Supreme Court re-wrote the ACA and made expansion of Medicaid up to 138% of poverty an option for the states. As of last June, about 24 states were resisting expansion for a number of reasons.
Medicaid is a program desperately in need of reform. Back in 2005/2006, I served on the Medicaid Commission – we did hearings around the country to look at the Medicaid program – to learn about it – because each state runs its own, it’s really 50 different programs. In our findings, people desperately dependent upon Medicaid and yet it was not serving them. If states were given more flexibility, they could make a significant amount of Medicaid dollars go much further to cover more people.
With this said, states are going to increasingly resist expansion of Medicaid unless they get more flexibility to control the program themselves and be able to save money and be able to provide better benefits to their citizens often in giving them the option of private coverage.
So what is the future of Medicaid? More governors demanding more flexibility; and then more patients on Medicaid getting more options for private coverage.
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