In 2023, three states — North Carolina, North Dakota, and South Dakota — expanded their Medicaid programs, bringing the total number to do so to 41. As 2024 nears, pressure will be on the remaining holdout states to follow suit. But whether the expansion has improved the health of the poor remains an open question.
Medicaid is the state and federal program designed to provide coverage for those in poverty. Enactment of the Affordable Care Act in 2010 required states to expand their Medicaid programs to cover up to 138% of the federal poverty level . The Supreme Court later ruled the federal government could not force states to expand the program but that states could opt in. Half of the states declined to expand Medicaid in 2014, the first year of expansion.
Hannes said WYA won’t request a Medicaid expansion bill in 2024 because Wyoming’s legislature will be focused on the state budget, making it harder for other issues to get a hearing. New research from the liberal Commonwealth Fund suggests that expanding Medicaid increases access to care for people who would otherwise fall in that gap.
One problem Owcherenko Schaefer points to is that many physicians either refuse to see Medicaid patients or refuse to take on new Medicaid patients. A 2019 survey by the Medicaid and Children’s Health Insurance Program Payment and Access Commission found that primary care doctors in expansion states were no more likely to see Medicaid patients than they were before the expansion.
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