Voters Have Expanded Medicaid in 6 States. Is South Dakota Next?
By Elizabeth Schultheis
After two years of waiting, Democrats and Republicans alike are ready to pass legislation to expand Medicaid in six states where voters have approved it. And while it’s still far away, the legislation is gaining enough momentum that the entire effort could be dead letter tomorrow.
But there’s a snag: The new laws include significant new restrictions on where, how, and by whom Medicaid plans can be offered. Medicaid expansion is popular with voters in many states—and, ironically, some who oppose the expansion have used the expansion as a way to get voters to approve measures they otherwise oppose.
As of Thursday morning, voters in Arkansas, Kansas, Missouri, Montana, and New Mexico had approved Medicaid expansion, according to the National Conference of State Legislatures. But those states—plus Michigan, Nebraska, New Hampshire, and New York—no longer include expansion in their state Medicaid programs.
And in the six states that do have expansion, the expansion has expanded quickly since last year. Arizona expanded the Medicaid program there more than 30 times since 1996, according to the U.S. Department of Health and Human Services. Now, state legislators there plan to pass two Medicaid expansion bills—one for next year and the other for this year—that would expand the nation’s largest health insurance program in the state, which is funded with a combination of state and federal dollars.
The most important state legislative push is in Kansas, which has had the most votes and the most states voting to expand Medicaid in the last five years. Its legislature passed a bill on May 9 that would expand the state Medicaid program and would establish requirements for participating health plans. When the state’s governor, Sam Brownback, takes office in January, both the legislature and the governor’s office will try to negotiate the specifics of the expansion with the federal government.
The governor’s office will not say whether Brownback will sign or veto the bill; he is expected to call a special session for the state legislature to pass the legislation. It’s likely Brownback will veto the expansion bill—as he did last year
