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As Trump Appoints Health Care Obstructor to Run Medicaid Program, New GAO Report Finds Widening Divide Between Medicaid Expansion and Non-Expansion States

By October 15, 2018No Comments

“This report is a call for change, yet the Trump Administration delivers more of the same sabotage” said Amanda Harrington

Washington, DC — At the same time as the release of a new report issued by the U.S. Government Accountability Office today finding a vast gulf in access to health care between people who live in states that have expanded Medicaid in contrast with those that have not, the Trump Administration announced that Governor Paul LePage’s former health-obstructer-in-chief Mary Mayhew has been tapped to lead Medicaid and CHIP.

The GAO report puts into sharp view the harm that can be done when officials like Mayhew block Medicaid expansion in their states. Among the report’s findings, low-income adults in states that expanded Medicaid were almost half as likely to have unmet medical needs, more than half as likely to forego medical care due to cost and nearly half as likely to report needing mental health care or prescription medication but not being able to afford it.

Amanda Harrington, spokeswoman for Protect Our Care, issued the following statement in response:

“The new GAO report is not only a call to action for states that haven’t expanded Medicaid yet, it’s a call for change in leadership. Medicaid expansion is front and center in many competitive governor’s races around the country, and this report shows why: Your ability to access medical care when you need it shouldn’t depend on who you are, how much money you make or what your ZIP code is, but unfortunately that’s the reality for far too many Americans living in states that refuse to expand Medicaid.

“Putting Mary Mayhew in charge of the critical Medicaid and CHIP programs, where she will actively be working to block people from the care they need, is just more Republican health care sabotage. Numerous times, Mary Mayhew and Governor Paul LePage have sought to obstruct the will of Mainers by blocking Medicaid expansion — and as this report shows, she did so at great cost to the people in her state.”


Key Findings from the GAO report, Access to Health Care for Low-Income Adults in States with and without Expanded Eligibility

  • An estimated 5.6 million uninsured, low-income adults—those ages 19 through 64—had incomes at or below the income threshold for expanded Medicaid eligibility as allowed under the Patient Protection and Affordable Care Act (PPACA); of these, 3.7 million live in non-expansion states.
  • Low-income adults in expansion states were less likely to report having any unmet medical needs compared with those in non-expansion states, and low-income adults who were insured were less likely to report having unmet medical needs compared with those who were uninsured.
  • Among the low-income adults who were uninsured, those in expansion states were less likely to report having any unmet medical needs compared with those in non-expansion states.
  • Low-income adults in expansion states were more likely to report having a usual place of care to go when sick or needing advice about their health and receiving selected health care services compared with those in non-expansion states.

As Medicaid’s Popularity Grows, It Has Become  a Key Issue in Competitive Governor’s Races

In Ohio, Cordray Blasts DeWine – Who Flip Flopped on Medicaid Expansion. “Cordray also dinged DeWine on Ohio’s Medicaid expansion, which provides health coverage to nearly 700,000 Ohioans. Republican Gov. John Kasich has ‘done some things that are very good for Ohio,’ Cordray said. ‘He had real courage on the Medicaid expansion, bringing that to Ohio and fighting the naysayers in his own party who said, ‘Gee, that’s part of Obamacare.’ And my opponent was part of those naysayers.’ DeWine now says he’ll keep the expansion. But Eck didn’t answer a question asking why, if he favored it, DeWine repeatedly sued to kill the law that made it possible.” [Columbus Dispatch, 9/20/18]

In Wisconsin, Democratic Challenger Targets Walker For Not Taking Federal Medicaid Expansion. “Evers made health care the focus of his only television ad to date, faulting Walker for not taking the federal Medicaid expansion and pointing out that the cost of an average health insurance plan sold on the private market this year in Wisconsin was more expensive than in Minnesota. Walker argues the ad is misleading and health insurance costs will decrease in Wisconsin once a recently approved reinsurance program takes effect.” [Minneapolis Star Tribune, 9/7/18]

In Maine, the Race For Governor Could “End Mediaid Standoff.” “Nearly 60 percent of voters said yes to the ballot initiative last November to approve expansion, but Republican Gov. Paul R. LePage — who is term limited  — has done everything he can to block its implementation, citing concerns over funding. Before it appeared on the ballot, he had vetoed bills to expand Medicaid five times, and now it’s tied up in an ongoing legal battle. Candidates who could follow LePage appear to be more open to implementing the ballot initiative. Democratic gubernatorial candidate Janet Mills has been a vocal supporter of Medicaid expansion. Independent candidates Terry Hayes and Alan Caron have also said they would implement it. The Republican candidate Shawn Moody previously seemed to follow LePage’s lead in opposing expansion, but now says he would implement the law as long as there is funding.” [Washington Post, 10/15/2018]

In Michigan, Candidates Gretchen Whitmer (D) And Bill Schuette (R) Spar Over Medicaid Expansion. “As attorney general, Schuette joined at least nine lawsuits fighting the Affordable Care Act. In a 2017 fundraising mailer, he said he opposed the law, ‘including the ‘free’ federal Medicaid dollars from Obama that leave Michigan taxpayers on the hook for more!’ ‘He has been the chief advocate against Healthy Michigan in our state ever since we started the bipartisan negotiations on it,” Whitmer told The Detroit News. ‘The biggest threat to health care in Michigan is Bill Schuette.’ But the Medicaid expansion program is threatened by declining federal aid, Schuette notes. The federal government fully funded the Medicaid expansion program the first three years, but the state began paying a share in 2017 and will be required to cover 10 percent of the costs by 2020. By then, it’s estimated to cost the state roughly $380 million a year.” [Detroit News, 9/18/19]

In Georgia, Democratic Candidate Stacy Abrams Has Said The First Thing She Would Do Is Expand Medicaid. “Democratic candidate Stacey Abrams has said the first thing she would do as governor is expand Medicaid. That’s the decision each state can make to give more low-income people access to health care. States receive federal funding for it, though they, too, have to pay into the program. ‘And you’ll hear me talk about this ad nauseam because it’s the only answer to Georgia’s challenges,’ Abrams said at a health care policy press conference Monday. ‘We have an uncompensated care rate of $1.7 billion.’…Republican Gov. Nathan Deal has refused to expand the program in Georgia, and Republican candidate Brian Kemp said he wouldn’t expand it either. ‘Government programs that aren’t working now are not a reason to give them more money,’ Kemp said at an event last week. Kemp said, instead, he favors opening up the private sector market to more competition to lower health care costs.” [WABE, 9/12/18]

In Alabama, Democratic Challenger Walt Maddox Is Running On Medicaid Expansion. “The Democratic nominee began the tour in Tuscaloosa where he is mayor. Describing himself as the only candidate in the race talking about the state’s “big problems”, Maddox is running on a platform of establishing a state lottery to fund education programs and expanding Medicaid. Standing with his wife, Stephanie and his two children, Maddox said the race is about ensuring the state’s children have opportunities.” [Associated Press, 9/17/18]
In Florida, Andrew Gillum is running on Medicaid Expansion, with polling showing Floridians want to expand Medicaid. “According to new data from the left-leaning think tank Data for Progress, an estimated 65 percent of Florida voters support expanding Medicaid across the state — and, amazingly, voters in every legislative or congressional district from the Keys all the way up to the Panhandle support the idea.” [Miami New Times, 5/25/18]

In Tennessee, Karl Dean is running on Medicaid Expansion, with polls showing voters support it strongly. “The poll, conducted by Mason-Dixon Polling & Research in April, showed 63 percent support Medicaid expansion with the use of federal funds to 21 percent against and 16 percent undecided.” [Nashville Tennessean, 5/7/18]