Dive Brief:
- Republican opposition to Medicaid expansion has led more than 20 states to reject it since 2012, and the states have appeared to hold the position of power on the decision, until now.
- Whether intentionally or not, the federal government now has Florida in a bind as it says that Medicaid funding for Florida's LIP program, which helps providers cover the costs of serving uninsured and low-income state residents, won't be renewed as-is. As a result, state legislators are considering a rush to expand Medicaid asap.
- Some say this is a sign that the Obama administration is now playing hardball, though unofficially, to get the hold-out states to go along with Medicaid expansion. HHS "appears to be using its leverage to try to convince recalcitrant states to do the expansion," Matt Salo, executive director of the National Association of Medicaid Directors, told the National Journal.
Dive Insight:
This move could signal the beginning of the end for Medicaid expansion hold-outs if similar pressure is ultimately wielded against the other states. As the National Journal notes, Texas, which would also be a major target for the administration, also has some Medicaid funding that currently helps pay for uncompensated care that is set to expire in 2016.
It isn't surprising that states rejecting Medicaid expansion may now be challenged by the administration when asking for other Medicaid funding.
"That raises a lot of questions for me and many other people," Joan Alker, executive director of Georgetown University's Center for Children and Families, told the National Journal. "Why would CMS go around handing out large sums of federal Medicaid dollars through that kind of backdoor arrangement in a state that's not expanding Medicaid and guaranteeing coverage for people who really need it?"