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Another Red State Governor to Expand Medicaid; Rick Perry Still Holding Out

by: Emily Cadik

Wed May 21, 2014 at 09:00 AM CDT

Governor Mike Pence of Indiana has become the latest red state governor to make the best choice for his state by expanding Medicaid.

Not one to align himself too closely with Obamacare, Pence is accepting Medicaid only with a twist - proposing his own version of the expansion. Under the Affordable Care Act, the federal government provides 100% of the cost for the first three years for states to extend Medicaid eligibility to those between 100% and 138% of the federal poverty level. After the first three years, the federal government gradually reduces its share to 90%.

Under Pence's plan, Indiana would accept the federal funds for expansion, but use the funds to offer private plans (rather than Medicaid per se) to low-income people. Pence, an outspoken opponent of the ACA, is billing his plan as an "alternative" to Obamacare. But it's clear that both the means and the ends will be similar - the state will accept significant funds from the federal government to help insure more low-income people.

Word on the street is that Montana may be next. And in addition to more states accepting the Medicaid expansion, Medicaid is expanding on its own even in states that haven't.

Read why after the jump.

In an ironic twist, Medicaid enrollment is increasing even in states that did not accept the Medicaid expansion because of the overall increase in health care enrollment outreach because of the ACA. There is still a major gap in coverage in the states that did not expand Medicaid (1 million in Texas alone) for people whose incomes are too high to qualify them for Medicaid without the expansion, but too low to qualify them for federal health insurance subsidies. But the nationwide enrollment efforts that ramped up during the open enrollment period over the past few months, and especially those in low-income communities, have still had the effect of getting more people enrolled.

According to a new study, Medicaid enrollment has increased by over 550,000 new beneficiaries across 17 of the 26 states that have not expanded Medicaid. Texas isn't exactly leading the pack, having seen only .1 percent growth in its Medicaid rolls. But other states have seen much higher figures - like Montana, whose rolls grew by over 10 percent, and Georgia, who added 98,000 people.

Beyond this slow but significant growth in the Medicaid program, it's only a matter of time before more and more red states give up their hardline anti-Obamacare positions in favor of accepting the tremendous amount of resources that the federal government will give them if they expand Medicaid.

Already more than 3 million people have enrolled in Medicaid because of the Affordable Care Act. One million more could be in Texas if Rick Perry ever sees the writing on the wall.  

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