April is Medicaid Awareness Month, and the Republican lawmakers in the states that have not yet expanded Medicaid now have even more reason to do so. In addition to taking bold steps to combat the COVID-19 pandemic, the American Rescue Plan includes robust incentives for the 12 states that have rejected Medicaid expansion under the Affordable Care Act (ACA). Despite the overwhelming benefits of Medicaid expansion, Republicans have spent years undermining the ACA and its expansion of Medicaid at every turn, blocking millions from coverage. Yet the program has become increasingly popular, with voters in Missouri and Oklahoma approving expansion through ballot initiatives just last year. Recent polling from Data For Progress confirms broad support for expansion in key holdout states: 

Medicaid expansion has always been a great deal for states; under current law, the federal government covers 90 percent of the cost for expansion. However, under the American Rescue plan, the remaining holdout states would receive an additional 5 percent increase in the federal funding match for their traditional Medicaid programs for two years — more than enough to cover each states’ cost for expansion. Local headlines make clear this deal is just too good to pass up. 

HEADLINES

(AL) Associated Press: Alabama Sizing Up Medicaid Expansion.“Alabama Gov. Kay Ivey and legislative leaders said they are reviewing details of the nearly $2 trillion coronavirus relief package that includes new financial incentives for the states that have opted against expanding Medicaid to provide health coverage for more low-income Americans. A spokeswoman for Ivey said the governor is ‘open to the discussion’ on expansion but that state leaders need additional information about the long-term cost projections.”  [Associated Press, 3/21/21

(AL) The Birmingham News: ‘We Could Call It KayCare’: Alabama Democrats Push Governor For Medicaid Expansion. “Several Democratic lawmakers are pushing Alabama Gov. Kay Ivey to accept more than $900 million in the COVID stimulus bill to expand Medicaid to the state’s low-income adults. ‘I don’t care whether we call it Obamacare,’ said Sen. Bobby Singleton, D-Greensboro. ‘We could call it Kaycare. It could be Alabama Health Care. But we need to expand Medicaid and the time to do it is right now.’[The Birmingham News, 3/16/21

(AL) Alabama Rise: 69% Of Alabama Voters Support Medicaid Expansion, New Poll Finds. ”Sixty-nine percent of Alabamians, including 64% of Republican voters, support expanding Medicaid when told about arguments for and against the idea, according to a new poll that the Cover Alabama Coalition released Wednesday…Both Republican and Democratic respondents were more likely to support Medicaid expansion with increased financial support from the federal government. A U.S. House bill would offer a dramatic increase in federal incentives for states like Alabama to expand Medicaid. If enacted, the legislation would provide an additional $940 million in federal money to Alabama over two years if the state expanded Medicaid.” [Alabama Rise, 2/17/21

(FL) WUSF: Medicaid Expansion Could Help Florida Overcome Budget Deficit, Advocate Says. “This year, the state is facing a $2 billion budget deficit, and lawmakers already are considering cuts to Medicaid payments. At the same time, Congress is considering expanding incentives that would provide billions of dollars to Florida and 11 other holdout states to expand Medicaid. Advocates say these incentives could help Florida overcome its budget deficit.” [WUSF, 3/3/21

(FL) WMFE: Explaining The American Rescue Plan’s $3.5B Incentive To Expand Medicaid In Florida. “Democrats are using the 11th anniversary of the Affordable Care Act to renew calls to expand Medicaid in Florida. The ACA originally called on states to expand Medicaid to all adults up to 133 percent of the federal poverty line. But Florida is one of 14 states that didn’t expand Medicaid. Now, the $1.9 trillion dollar American Rescue Plan offers a new incentive: It would cover 90 percent of the cost to enroll an estimated 800,000 Floridians in Medicaid. And it would increase the federal pay rate for all Medicaid enrollees for the next two years. Together, that would bring an estimated increase of $3.5 billion dollars into Florida.” [WMFE, 3/23/21

(FL) Florida Politics: Democrats Lobby Florida Legislature To Expand Medicaid, Grab New Federal Dollars Under COVID-19 Relief Bill. “Florida Democrats and health care advocates are pushing the GOP-controlled Legislature to take advantage of new federal incentives to expand Medicaid in Florida…A new provision in the American Rescue Plan provides even more federal dollars to encourage Medicaid expansion in any state that has not already expanded those benefits. Florida is one of 12 states that falls into that bucket. The additional federal dollars would trickle in for two years, and could cover another 5% of costs for people covered.” [Florida Politics, 3/23/21

(FL) Palm Beach Post: Ted Deutch, New HHS Chief Tout Stimulus, Call On Florida To Expand Medicaid. “Then there are the new incentives to expand Medicaid in the state, Deutch and others said. Florida could end up with more than a billion dollars in federal funding above the cost of paying for broader Medicaid enrollments because of matching funds to help pay for existing enrollees on top of payments for expansion. As a result, the state would reap additional dollars in addition to providing Medicaid health coverage for another 1 million Floridians if the federal program were expanded, said Leslie Dach of Protect Our Care.” [Palm Beach Post, 3/23/21

(GA) Georgia Recorder: Georgia Dems Urge State To Accept Sweetened Medicaid Expansion Deal. “Georgia Democrats called on the state’s GOP leadership to take advantage of new federal incentives to fully expand Medicaid that were baked into the $1.9 trillion COVID-19 relief package President Joe Biden signed last week. Georgia is one of a dozen states that did not expand Medicaid under the Affordable Care Act, with Republicans calling it too costly in the long run.” [Georgia Recorder, 3/15/21

(GA) Atlanta Journal Constitution: With Pandemic Relief Plan, Democrats Try To Spur Georgia To Expand Medicaid. “Republican leaders in Georgia have adamantly opposed expanding the program to cover more low-income adults, saying it would be too costly in the long run and deny state health officials flexibility. But the $1.9 trillion stimulus aims to make resistance harder by including an infusion of about $2 billion to the state to cover the full tab of Medicaid expansion for two years.” [Atlanta Journal Constitution, 3/11/21

(KS) Topeka Capital-Journal: Joe Biden’s COVID-19 Relief Bill Could Give Kansas An Extra $450M ― If It Expands Medicaid. “Kansas remains one of 12 states to not adopt provisions of the Affordable Care Act, which would expand Medicaid to at least 130,000 to 160,000 low-income people. But Congress is expected to pass its next COVID-19 relief package Wednesday, and national Democrats have tucked in a section aimed at enticing states that haven’t expanded Medicaid to do so.” [Topeka Capital-Journal, 3/10/21

(KS) The Kansas City Star (Editorial): Kansas, You Are Out Of Excuses. COVID Relief Would Pay For Expanding Medicaid. “Year after year, stingy state legislators have said Kansas simply can’t afford Medicaid coverage for another 165,000 residents. Too bad about the closing of rural hospitals, they said. Such a shame about poor health outcomes in urban areas. It was just too expensive, they argued. But the recent passage of Congress’ pandemic relief package has rendered that argument moot. The bill provides more than $16 billion for states that haven’t expanded Medicaid, including Kansas, making it essentially cost-free for the next two years.” [Kansas City Star, 3/17/21

(MS) Clarion Ledger: Mississippi Insurance Commissioner: What Medicaid Expansion Would Mean For The State. “The federal pandemic relief bill contains a big incentive for states that haven’t expanded Medicaid. Mississippi is one of 12 states holding out on the expansion. State Insurance Commissioner Mike Chaney says currently the federal government pays about 80 cents on the dollar for Medicaid coverage. If Mississippi were to expand, that amount would increase to 95 cents. Chaney says Medicaid expansion could provide health care coverage options for those who do not currently qualify under the Affordable Care Act.” [Clarion Ledger, 3/30/21

(MS) Northeast Mississippi Daily Journal (Editorial): Expanding Mississippi Medicaid Makes More Sense Than Ever. “The case for expanding Medicaid got a lot stronger this month, to the point that most any reasonable, rationale consideration would conclude that now is the time for Mississippi to do so…But the recently passed COVID-19 relief bill made the offer even more enticing by including billions of dollars for the 12 states that have not expanded Medicaid. In addition to covering 90% of new Medicaid enrollees for two years, the federal government has agreed to cover approximately 5% of the cost for current enrollees — an estimated $16.4 billion if all 12 states took the deal.” [Northeast Mississippi Daily Journal, 3/28/21

(NC) Charlotte Observer (Editorial): Medicaid Expansion Comes Knocking Again In NC. This Time It’s A Better Deal. “Now President Joe Biden is making a pitch to North Carolina and 11 other holdout states in an effort to extend health insurance to millions of people who are braving the pandemic without it. Biden’s $1.9 trillion COVID-19 relief package has passed by the House and is awaiting a Senate vote. The plan provides an incentive for states to expand Medicaid by temporarily increasing federal Medicaid payments by 5 percent for two years for states that newly expand Medicaid.” [Charlotte Observer, 3/1/21

(NC) WRAL (Editorial): Take The Money, It’s Ours. Expand Medicaid. “There are no good reasons for North Carolina not to expand Medicaid coverage to as many as 650,000 North Carolinians who now lack affordable access to health care…The federal COVID-19 relief legislation that appears to be headed to the president offers North Carolina between $1.7 billion and $2.4 billion in ADDITIONAL federal medical assistance percentage (FMAP) funds over two years – that would be on top of the cost of covering Medicaid expansion.” [WRAL, 3/10/21]

(NC) WRAL (Editorial): Expand Medicaid Now. It’s GOOD Policy. “As has been pointed out repeatedly, there is Medicaid expansion funding in the recently enacted federal COVID-19 relief legislation. Those are dollars – estimated from between $1.7 billion to $2.4 billion — North Carolina taxpayers send to Washington and won’t come back without being used to help keep more North Carolinians healthy. It would provide a significant reduction in the uncompensated care costs hospitals have to shoulder for treating uninsured patients. Hospitals in Louisiana saw those costs reduced by a third as a direct result of that state’s expansion of Medicaid. Expanding Medicaid in the state would generate thousands more jobs and increase ‘business activity by $11.7 billion over three years, between 2020-2022. It’s money that could be spent on education, infrastructure and other needs.’” [WRAL, 3/17/21

(SC) Charleston City Paper: SC Has Big, New Incentive To Expand Medicaid To Cover 200K, But Will It? “State coffers could get $2.5 billion in new federal funding over two years if lawmakers get over longstanding political objections to expand Medicaid to cover about 200,000 residents without health insurance.  At present, many agree expansion is more of a possibility than a probability due to the state’s political climate. The new funding over two years would come from a 90% federal match of health insurance costs plus a new federal incentive of about $790 million with few strings attached, analysts say.” [Charleston City Paper, 3/25/21]

(SD) PBS NewsHour: Support For Medicaid Expansion Grows In South Dakota, One Of The Last Red State Holdouts. “South Dakota would wind up spending less on health care in the future by expanding Medicaid, because the federal government would pick up a larger share of the costs for services such as prenatal care for residents who are already enrolled in the program. Hospitals and clinics would also see a decline in uncompensated care costs for treating uninsured patients as more people without insurance enroll in Medicaid, health care experts said. Under the Affordable Care Act, the federal government would cover 90 percent of the costs for expanding the program to more people, leaving South Dakota to chip in just 10 percent of the additional funding. The pandemic relief bill Biden signed last week includes extra federal funding for states that haven’t yet expanded Medicaid if they choose to do so.” [PBS NewsHour, 3/16/21

(TN) Nashville Tennessean: Tennessee Republicans Open To Medicaid Expansion Talks As Biden Sweetens Deal. “Tennessee could offer TennCare coverage to hundreds of thousands of moderately poor residents while also saving as much as $900 million in state money over two years if lawmakers expand Medicaid under a sweetened deal proposed by the White House. These new incentives, offered by President Joe Biden’s coronavirus stimulus law, have prompted at least one prominent Republican leader to reconsider expansion after his party opposed it for a decade.” [Nashville Tennessean, 3/23/21

(TN) WKRN: Top Republicans Are Split On Medicaid Expansion Incentives That Could Top $1 Billion. “New incentives in the latest COVID-19 relief package will give Tennessee the option for millions of dollars to cover the healthcare cost of 300,000 Tennesseans if the General Assembly decides to expand Medicaid. Tennessee Democrats are renewing their hope that the state will expand Medicaid under new standards from the federal government.” [WKRN, 3/27/21

(TX) House Chronicle: Latest Covid Relief Bill Expands Aid For 3.9 Million Texans Living In Poverty. “The stimulus also includes another attempt at getting Texas to expand Medicaid, something Republicans in Austin have long resisted, suspicious that the federal government will eventually shift the costs of the program onto the state. An estimated 1.4 million uninsured Texans would be eligible for Medicaid if it were expanded. The stimulus boosts the federal share of the cost of expansion by 5 percentage points — a move pushed by U.S. Rep. Lizzie Fletcher, a Houston Democrat, who said the provisions are ‘vital to helping incentivize states like Texas and the others that have not expanded Medicaid to do so.’” [Houston Chronicle, 3/9/21

(TX) San Antonio Express-News (Editorial): On Medicaid, Texas Defies Logic, Fiscally And Morally. “There is simply no compelling reason for Texas to refuse to expand Medicaid, and yet here we are, stuck with the highest uninsured rate in the nation because the majority of Republican lawmakers just can’t go there. It is doubly tragic. The numbers speak for themselves. Before the pandemic, Texas had an uninsured rate of 18.4 percent. That’s almost certainly risen with unemployment in the time of COVID.” [San Antonio Express-News, 3/9/21]  

(WI) Wisconsin Examiner: Expanding BadgerCare In Wisconsin Could Become An Even Sweeter Deal. “Under [the] new COVID bill, $1.3 billion would be dangled in front of Wisconsin, but only if it expands Medicaid…U.S. House Democrats are trying again to entice holdout states, including Wisconsin, to expand Medicaid coverage with the prospect of billions of dollars in federal cash. This money would be on top of the already large net benefits the state would realize under existing law through expansion.” [Wisconsin Examiner, 2/11/21

(WI) Wisconsin State Journal: Report: Medicaid Expansion Could Mean $1.6 Billion More For State Over Next 2 Years. “Wisconsin could save more than $1.6 billion over the next biennium by expanding Medicaid, raising the stakes significantly on Republicans who remain steadfastly opposed to the move. The federal COVID-19 relief bill Congress passed Wednesday would provide Wisconsin more than $1 billion in new, temporary savings if the state adopts Gov. Tony Evers’ call for Medicaid expansion in the upcoming budget, according to a new report by the nonpartisan Legislative Fiscal Bureau.” [Wisconsin State Journal, 3/11/21

(WY) Casper Star Tribune (Editorial): It’s Time To Expand Medicaid In Wyoming. “Put simply, Medicaid expansion addresses a critical problem that has persisted in Wyoming. And it does so while also providing millions of dollars in revenue at a time when it’s badly needed. Viewing this reality through a nonpartisan lens reveals just how much our state can benefit. Opponents of expansion are out of excuses. The law is clearly not going anywhere. It’s not going to collapse under its own weight. And if there was a better, Wyoming specific solution, someone would have offered it by now.” [Casper Star Tribune, 3/14/21

(WY) Associated Press: Wyoming Edges Closer To Medicaid Expansion. “Although Congress has not yet passed the legislation, Biden’s strategy appears to be working. A key Wyoming Senate committee this week approved a measure that would extend Medicaid benefits to all poor adults—not just older adults, those with disabilities and pregnant women. The bill now moves to the Wyoming Senate floor. If it passes, the law would add about 24,000 Wyoming residents to the Medicaid rolls, according to estimates released by the state’s Department of Health last month.” [Associated Press, 3/9/21

(WY) Medicaid Expansion Bill Gains Approval In Wyoming House. “Wyoming lawmakers have attempted to expand health insurance for low-income residents through Medicaid expansion for nearly a decade, and each attempt thus far has been defeated, often early in the legislative process. House Bill 162 still requires two additional readings in the House before heading to the Senate. But several staunch opponents to expansion over the years are now in support of the effort. Those who have found themselves advocating for legislation they previously opposed include Rep. Steve Harshman, R-Casper.” [Casper Star Tribune, 3/22/21