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January 2013 St@teside

States Contemplate Medicaid Expansion

Governors from around the country have been announcing their state fiscal year 2014 budgets, slowly clarifying the picture of which states are planning to implement the Medicaid expansion. Both 
StateRefor(u)m and American Health Line have compiled summaries of state positioning on the expansion issue.

According to American Health Line (based primarily on press statements by the governor), 10 states have proactively said they will not implement a Medicaid expansion (Alabama, Georgia, Idaho, Louisiana, Maine, Mississippi, South Carolina, South Dakota, Oklahoma, and Texas); five states are leaning toward not implementing (Iowa, Nebraska, New Jersey, Virginia, and Wyoming); five states are leaning toward implementation (Kentucky, New Hampshire, New York, North Dakota, and Oregon), 18 states and the District of Columbia are making proactive statements that they plan to participate in the expansion, and 12 states are either undecided or making no comment.













Via: The Advisory Board Company

States are analyzing the budget impact of participating in the Medicaid expansion. Click 
here for a list of state budget and economic impact studies. Several governors have cited cost in announcing their opposition to expansion, though other states have shown budget savings (because federal funds can replace existing state funds) and a few also have shown a positive economic impact due to increased federal resources that will enter the state economy.

For a handful of states that had previously expanded coverage, there is interest in providing state assistance to those with incomes above 138 percent of the federal poverty level.  
CaliforniaMassachusettsMinnesota and Vermont have all made public statements expressing interest in finding a way to provide better or expanded benefits than those that will be found in the exchange.