Amid all the Obamacare extensions and fixes, there is one thing the White House can't change — state decisions on Medicaid expansion.
That's where it's up to residents to take action, President Obama said in an interview with WebMD posted Friday. The president answered questions from the online community to promote the Affordable Care Act ahead of the March 31 enrollment deadline.
"We don't have the ability at the federal level to pressure these states to do what they should be doing," Obama said. "Hopefully, citizens in those states, as they look at neighboring states that are expanding Medicaid, will say: 'Well, why would you — Mr. Governor, or members of the state legislature — choose deliberately to leave people in our state uninsured, particularly when it doesn't cost our state any money?' "
Under the ACA, Medicaid is extended to all individuals at or below 138 percent of the federal poverty level. The federal government will cover the 100 percent of the cost for the first three years, until 2016. After that, the federal contribution decreases to 90 percent by 2020, where it will remain.
Currently, 25 states plus the District of Columbia are moving forward with Medicaid expansion, 19 are not, and six are still deliberating. Those that have opted out are all Republican-run states.
"This is a source of great frustration for me," Obama continued. "For political reasons, a number of states have chosen not to take us up on that, and the Supreme Court said we could not condition other programs, like existing Medicaid programs, on them accepting it."
The Court ruled in 2012 to leave the decision up to the state governments. States can change their mind and decide to opt in to Medicaid expansion at any point.
That change, however, is dependent on state residents pressuring their representatives to join the program.
"We've seen some states where Republican governors have said, 'You know, this is the right thing to do,' even if they don't agree with the president," Obama said. "And they've gone ahead and done it and people have benefited from it. And I hope that ends up being true in all 50 states; right now it's not true in a number of states, including some big states like Texas, where a lot of people are being impacted."
Watch the full interview at WebMD.