For this week's 2306 written assignment. Medicaid is the largest of the programs that fall under the category of "cooperative federalism."
I've asked students to outline the issue raised in this article.
- Click here for the article.
The fate of Medicaid expansion, a central tenet of President Obama's signature health-care legislation, is in the hands of the people in several states.
In Idaho, Nebraska and Utah, voters will decide whether to make more low-income people, those up to 138 percent of the federal poverty line, eligible for Medicaid, the government-run health insurance program. In most of the other states, who voters elect as governor and to the legislature will influence the direction of this health-care policy for years to come.
Since the Affordable Care Act passed in 2010, 33 states have expanded Medicaid, largely along partisan lines, with Republicans leading the holdout movement. But in some cases, Republican governors tried for years to convince their GOP legislatures to expand.
Health policy experts say that, generally, a state's status of expansion guides which races are most important to watch in the midterms.
"For a state that hasn’t yet expanded, the governor can’t do it all, so you have to watch what happens with the legislature," says David Jones, associate professor of health law at Boston University who recently examined where Medicaid expansion appears more vulnerable. "But for states that have already expanded, the legislature doesn’t matter as much" because the governor has authority to tweak the current law or to end expansion in some cases.
The midterms come at a crucial time for health care. The Trump administration gave states the greenlight to adopt new rules for Medicaid that the Obama administration rejected. For instance, Arkansas, Kentucky, Indiana and New Hampshire have been approved to add work requirements, and several other states have applied. In July, a federal judge struck down Kentucky's work requirements plan, putting the rest of the states' policies into legal jeopardy. Despite the ruling, the Trump administration has signaled that it plans to proceed with work requirements.
