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The Other Important Number In The President's Obamacare Briefing: 24

Apr 17 2014, 9:53pm CDT | by

President Obama was triumphant on Thursday. After facing months of questions over whether the White House would hit its goal of 7 million Obamacare sign-ups, the president had the latest enrollment...

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15 weeks ago

The Other Important Number In The President's Obamacare Briefing: 24

Apr 17 2014, 9:53pm CDT | by

President Obama was triumphant on Thursday.

After facing months of questions over whether the White House would hit its goal of 7 million Obamacare sign-ups, the president had the latest enrollment data in hand—and it was a bigger number than almost anyone expected.

“The number of Americans who’ve signed up for private insurance in the marketplaces has grown to 8 million people,” the president said, standing in the White House press briefing room. “This thing is working.”

But President Obama took his moment at the podium to take a shot at the governors that have said no to the Affordable Care Act’s Medicaid expansion. For one reason or another, 24 states are still sitting out. (See the map of states below.)

“You got 5 million people who could be having health insurance right now, at no cost to these states,” the president said. “That’s wrong.”

The White House simultaneously released a fact sheet arguing that 5.7 million people would not have health coverage in 2016 if those 24 states continue to sit out of the expansion.

“This does frustrate me,” the president added, arguing that the states “have chosen not to expand Medicaid for no other reason than political spite.”

Republican leaders say that’s not fair criticism, and have offered a range of policy and financial reasons why they’ve said no to Medicaid.

  • Texas Gov. Rick Perry has argued that the existing Medicaid program is untenable and a budget-buster;
  • Louisiana’s Bobby Jindal said he’s growing less interested in the Medicaid expansion as private Obamacare enrollments tick up, presumably because his state’s residents will be able to shop on the insurance exchange; and
  • Florida’s Rick Scott, who famously did want to opt into the Medicaid expansion, has essentially abandoned the effort because of resistance within his state, the Washington Post‘s Jason Millman notes.

It wasn’t supposed to be this way, of course. The framers of Obamacare envisioned the Medicaid expansion as mandatory, and very few experts expected that the provision would be affected by the legal challenges to the ACA.

But ever since the Supreme Court’s surprise ruling in 2012 that the Medicaid expansion was optional, state leaders were pushed into making a call on whether they wanted the provision and its Obamacare dollars, or wanted to sit out for now.

We’ve been keeping a rolling tracker of those state-by-state decisions at the Advisory Board Daily Briefing.

Below, I’ve pasted our latest Daily Briefing chart of where the states stand—the 24 holdouts are generally across the South and the Midwest—and you can find a detailed state-by-state rundown here.

The state-by-state map of Medicaid expansion is the “most important ACA-related chart, in my view,” Austin Frakt posted on Twitter. (Frakt’s the co-editor-in-chief of the influential Incidental Economist blog and a New York Times contributor.)

Why’s that? Because the Medicaid expansion represents a crucial tool to achieve the law’s goal of coverage expansion, perhaps even more than Obamacare’s insurance exchanges. Notably, the Medicaid expansion was originally projected to help 16 million Americans—many of them too poor to shop on the marketplaces, and millions of them previously uninsured—obtain coverage by 2019; because of the states are still opting out, the CBO has cut back that projection to 12 million.

Somewhat paradoxically, covering more patients through Medicaid also was expected to be a factor in Obamacare’s ability to tamp down health spending; because Medicaid pays lower reimbursement rates than private insurance, hospitals and doctors that see more Medicaid-related volumes might be forced to cut their costs and run more efficiently.

The trickle-down effect on providers’ finances is notable, too. Some struggling hospitals in states like North Carolina and Georgia have blamed their bankruptcies on their state’s decision to opt of the Medicaid expansion, even as other Affordable Care Act-related cuts to reimbursement take effect.

It’s still unclear if those states’ decisions are really playing a role in the short-term, but my Advisory Board colleagues modeled out the long-term impact of a state refusing to expand Medicaid. They found that deciding to opt out of Medicaid would ultimately lead to a 2.5-percentage point reduction in the average hospital’s margins—a notable hit, given that a hospital’s margins are usually just a few points above zero to begin with.

 
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7 weeks ago

RM47mil KWSG contributions still unclaimed

Jun 9 2014 7:54am CDT | Source: Business Times Malaysia

KUALA LUMPUR: About RM47 million of contributions in the Teachers Provident Fund (KWSG) still remain unclaimed, the Dewan Rakyat ...
Source: Business Times Malaysia   Full article at: Business Times Malaysia
 

 
Update
9

7 weeks ago

Gold shop lost almost RM1mil

Jun 9 2014 3:50am CDT | Source: Business Times Malaysia

KANGAR: A gold shop owner lost almost RM1 million after after the safe on in his shop was broken int ...
Source: Business Times Malaysia   Full article at: Business Times Malaysia
 

 
Update
8

7 weeks ago

Motion to debate MAS losses in Dewan Rakyat rejected

Jun 9 2014 3:39am CDT | Source: Business Times Malaysia

KUALA LUMPUR: AN emergency motion to debate the losses incurred by Malaysia Airlines last year, amounting to RM1.2 billion was rejected by the Dewan Raky ...
Source: Business Times Malaysia   Full article at: Business Times Malaysia
 

 
Update
7

7 weeks ago

MH370 Tragedy: Hisham: RM27.6 mil spent on 1st phase of SAR

Jun 9 2014 2:11am CDT | Source: Business Times Malaysia

KUALA LUMPUR: Malaysia spent some RM27.6 million in its first phase of the search operations for missing Malaysia Airline flight MH370, said Acting Transport Minister, Datuk Seri Hishammu ...
Source: Business Times Malaysia   Full article at: Business Times Malaysia
 

 
Update
6

7 weeks ago

9.1m litres of diesel seized in a month

Jun 8 2014 1:11am CDT | Source: Business Times Malaysia

PUTRAJAYA: The Domestic Trade, Cooperatives, and Consumerism ministry has seized some 9.1 million litres of diesel and property worth RM58 million since mounting ‘Operasi Diesel Selatan’ in the southern states last month. ...
Source: Business Times Malaysia   Full article at: Business Times Malaysia
 

 
Update
5

8 weeks ago

Girl, 9, awarded RM2.78m compensation for medical negligence

Jun 6 2014 4:56am CDT | Source: Business Times Malaysia

KUALA LUMPUR: A nine-year-old girl who suffered brain damage during her birth at a government hospital was awarded over RM2.78 million in ...
Source: Business Times Malaysia   Full article at: Business Times Malaysia
 

 
Update
4

8 weeks ago

Malaysia's total trade in April up 12pc

Jun 5 2014 11:52pm CDT | Source: Business Times Malaysia

KUALA LUMPUR: Malaysia's total trade in April 2014 rose by 12 per cent from a year ago to RM123.86 billion due to growing trading activities, International Trade and Industry Min ...
Source: Business Times Malaysia   Full article at: Business Times Malaysia
 

 
Update
3

8 weeks ago

Works Ministry to spend RM20m for upgrading works at 50 accident black spots

Jun 4 2014 11:35pm CDT | Source: Business Times Malaysia

JOHOR BARU: The Works Ministry will implement upgrading works at 50 accident prone locations in the country that have been identified this year involvi ...
Source: Business Times Malaysia   Full article at: Business Times Malaysia
 

 
Update
2

8 weeks ago

Najib launches loan scheme for Ramadan traders

Jun 4 2014 10:24pm CDT | Source: Business Times Malaysia

PUTRAJAYA: Prime Minister Datuk Seri Najib Razak today launches RM45 million Ramada ...
Source: Business Times Malaysia   Full article at: Business Times Malaysia
 

 
Update
1

8 weeks ago

Residents bring up objection against Kidex to Suhakam

Jun 4 2014 4:49am CDT | Source: Business Times Malaysia

PETALING JAYA: A group of 20 Petaling Jaya residents held a meeting with the Human Rights Commission of Malaysia (Suhakam) over their objection against the proposed RM2.2 billion Kinrara Damansara S ...
Source: Business Times Malaysia   Full article at: Business Times Malaysia
 

 

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