Obama: Pressure Your State to Expand Medicaid

When it comes to changing state decisions on Medicaid expansion, the administration’s hands are tied, the president said in an interview Friday.

US President Barack Obama speaks during an event honoring 2012-2013 NCAA Division I College Mens and Womens Champions on the South Lawn of the White House in Washington on March 10, 2014. AFP PHOTO / Saul LOEB 
National Journal
Sophie Novack
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Sophie Novack
March 14, 2014, 9:17 a.m.

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.

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