With the Affordable Care Act's premium subsidies protected for now, the Obama administration and the hospital industry are stepping up their efforts to persuade the 21 holdout states to expand Medicaid to low-income adults.
President Barack Obama spoke last week in the capital of Tennessee, a state where Republican Gov. Bill Haslam recently was blocked by the GOP-controlled Legislature in his effort to establish a conservative-friendly version of Medicaid expansion. Last month's U.S. Supreme Court decision in King v. Burwell preserved subsidies for 156,000 Tennesseans.
An obviously upbeat Obama talked about pushing ahead with healthcare reform. “One thing I'm hoping is that with the Supreme Court case now behind us, we can focus on how to make it better,” Obama said during his speech at Nashville's Taylor Stratton Elementary School, which was attended by a who's who of healthcare leaders. “There are still areas of improvement and there are still people who are uninsured.”
Since the ruling, Democratic governors in Alaska, Missouri and Virginia have indicated they want to reopen discussions about expanding Medicaid, as has Haslam. Meanwhile, Republican-led Utah is in talks with the administration about an expansion model. Supporters hope the King ruling will give their cause momentum. But opposition to the ACA and Medicaid expansion remains powerful among Republicans, fueled by fiery anti-Obamacare campaign statements from presidential hopefuls, including the governors of Louisiana and Wisconsin.
Obama mentioned Medicaid expansion only obliquely in his prepared remarks. But pressed by an audience member, the president said states that have expanded Medicaid have reduced their uninsured rate more quickly than other states. “Here in Tennessee, that's probably a couple hundred thousand people who could benefit,” he said. “Given the strong history of innovation of healthcare in Tennessee ... you all should be able to find a solution. The federal government is … ready to work with the states that want to get going.”