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GOP Gubernatorial Wins Bode Poorly for Hopes of More Medicaid Expansion

GOP Gubernatorial Wins Bode Poorly for Hopes of More Medicaid Expansion

November 6, 2014 — The status of states' Medicaid expansion under the Affordable Care Act (PL 111-148) is unlikely to change substantially following the midterm election on Tuesday, given Republican victories in key gubernatorial elections, the New York Times' "The Upshot" reports.

GOP governors who were re-elected in Kansas, Maine and Wisconsin all oppose Medicaid expansion, meaning their states' programs are unlikely to change. Florida Gov. Rick Scott (R) -- also re-elected on Tuesday -- has expressed support for expansion, but he has never pushed forcefully for it, suggesting the program is unlikely to expand in his state over the next few years.

In addition, Arkansas Republican Gov.-Elect Asa Hutchinson has been tepid in his support for the state's alternative expansion of its Medicaid program -- a "private option" approach under which the state uses federal Medicaid funding toward the purchase of private health plans for low-income residents. Further, Medicaid expansion opponents picked up two key state Senate seats in Arkansas, which might make it more difficult to reauthorize the alternative program.

Meanwhile, Pennsylvania's Republican Gov. Tom Corbett (R) lost to Democrat Tom Wolf, which means that the state's alternative Medicaid expansion plan -- which was adopted under Corbett and includes some elements that Democrats oppose -- could change when Wolf is in charge.

Alaska remains the sole state where a new move to expand Medicaid could still happen, depending on who is ultimately declared the victor in the race between Gov. Sean Parnell (R) and challenger Bill Walker (I). Walker has voiced support for expansion, while Parnell opposes it (Barro/Sanger-Katz, "The Upshot," New York Times, 11/4).

HHS Sec. Burwell Open To Working With Governors

Meanwhile, HHS Secretary Sylvia Mathews Burwell on Tuesday said Medicaid expansion would remain among her "top priorities" and urged newly elected governors to contact her if they are interested in expanding their states' Medicaid programs, The Hill reports.

During a speech to the National Association of Medicaid Directors, Burwell said HHS is "eager and willing to work with states that have yet to expand." She added, "My message to governors is that, 'If you're interested in expanding, call me.' And to those governors who are about to get elected or re-elected today, my message is that 'I'm happy to meet with you before your inauguration'" (Viebeck, The Hill, 11/4).