Health Reform 2.0: Governors Pushing Back on Medicaid Expansion

Opt-out in Affordable Care Act could leave millions of low-income Americans still uninsured

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Haislmaier and others suggest that state resistance to the Medicaid expansion raises an opportunity for compromise.

"If you're a smart governor, you're going to say to the feds, 'Well, how about we negotiate about this?' because now I no longer have to do this," he said, citing the Supreme Court ruling.

The federal government often grants waivers giving states some flexibility in operating their Medicaid programs.

"I would say that there are a number of states who are ready to have that discussion," Salo said. "I would say that the administration is not, because there's still a lot of questions about the post-Supreme Court ACA that are very much unresolved."

Much will depend on who takes over the White House after Election Day, Nov. 6. "This is a waiting game," Haislmaier said.

More information

To learn more, read the Kaiser Commission report Who Benefits from the ACA Medicaid Expansion?

To read part one of this series, "States Balking at New Insurance Exchanges,"click here.

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