An effort by Republican governors in Medicaid expansion states to show the expansion is worth keeping is unlikely to influence congressional Republicans in their drive to repeal the Affordable Care Act and its expansion of coverage to low-income adults, Republican experts say.
Instead, congressional Republicans are expected to push ahead to repeal the Medicaid expansion and convert Medicaid from an entitlement to a capped program of federal contributions to the states, said Jon Gilmore, a Republican strategist in Arkansas.
That would give state officials far greater leeway to set eligibility and benefit levels but likely would sharply reduce federal contributions over time. Critics say this type of block grant or per capita grant approach would lead to states reducing enrollment, trimming benefits and cutting payments to providers. Democrats are expected to strongly oppose this initiative.
But Medicaid expansion advocates hope the governors' lobbying will cause congressional Republicans to think twice before wiping out the coverage extension that has brought billions of federal dollars into their states.
Last week, Ohio Gov. John Kasich said expansion has been key to battling opioid addiction in his state, where about 700,000 people have gained Medicaid coverage. “Thank God we expanded Medicaid because that Medicaid money is helping to rehab people,” Kasich said.
His administration recently released survey data showing 75% of the people who gained Medicaid coverage were uninsured before becoming eligible for Medicaid, and that more than 1 in 4 have been diagnosed with at least one chronic condition. The report said expanding Medicaid has reduced emergency department use, improved self-reported health, and supported employment and job-seeking.