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Akron Univ. School of Law

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Wednesday, June 24, 2009

Expanding Medicaid: Some States Wary

The Wall Street Journal reports on some concerns of state governors about expanding Medicaid.  Jonathan Weisman writes:

Some governors are pushing to scale back or kill proposals to expand Medicaid to provide health-care coverage to the uninsured, raising a new challenge to President Barack Obama's effort to overhaul the system.

Medicaid, the health-care program for the poor, is funded through a combination of federal and state tax money. Proposals in the House and Senate would expand the program to cover at least a third of the nation's 46 million uninsured, but states are worried they would get stuck with a big part of the tab. . . .

Sen. Diane Feinstein, a California Democrat, said Sunday the issue could be a deal breaker for her.  California is in "a state of financial catastrophe," she said on CNN's "State of the Union." "[I]f you change the Medicaid rate, for example, it has an impact on California between $1 billion and $5 billion a year. Now, how could I support that?" she asked. "It would take down the state."

Currently, government-sponsored coverage of children offered by a combination of Medicaid and the State Children's Health-Insurance Program generally extends to 200% of the poverty line, or $36,620 for a family of three, $44,100 for a family of four. Parents are generally covered by Medicaid up to 67% of the poverty line, or $14,800 for a family of four. Adults without dependent children often aren't covered by Medicaid at all.

The House Democratic plan would offer coverage to any uninsured American with incomes up to 133% of the poverty line, with the federal government assuming all the cost of expansion. Proponents haven't said what that will cost. A proposal by the Senate Health, Education, Labor and Pensions Committee may go up to 150% of the poverty line. The federal government would assume all the cost for five years. During the next five years, the states would gradually assume half the cost. The Senate Finance Committee is working on legislation along the same lines, but not as generous. Pregnant women would be covered up to 150% of the poverty line. Childless adults could be closer to 115%, a senior committee aide said.

White House officials appear to be looking at other options for the uninsured poor. . . .

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