U.S. Senator Tammy Baldwin Encourages States to Expand Medicaid with New Legislation

WASHINGTON, D.C. – U.S. Senator Tammy Baldwin joined several of her colleagues in introducing a new reform to ensure that states that choose to expand eligibility for Medicaid after 2014 may access the same level of federal matching funds as states that expanded earlier under the terms of the Affordable Care Act. The States Achieve Medicaid Expansion (SAME) Act of 2016 was introduced by Senators Mark R. Warner (D-VA), Debbie Stabenow (D-MI), Claire McCaskill (D-MO), Jon Tester (D-MT), Tammy Baldwin (D-WI), Angus King (I-ME), Tim Kaine (D-VA) and Gary Peters (D-MI).                            

“In Wisconsin, Governor Walker has put politics ahead of progress and taken our state in the wrong direction. Instead of accepting a federal investment in our BadgerCare program and expanding Medicaid coverage, he has kicked Wisconsinites off their coverage, created a coverage gap, and exposed Wisconsin taxpayers to higher costs while covering fewer people,” said Senator Baldwin. “I support this legislation because it is my hope it will point our state in the right direction.”

“States across the country have already expanded Medicaid in a way that works for their needs because it is morally and economically the right thing to do. States that choose not to expand Medicaid – and that includes my own state of Virginia – are making the conscious decision to send their tax dollars to other states that have. They are also allowing health care costs for the uninsured to be passed along to taxpayers in the form of emergency room visits and increased care costs,” said Senator Warner. “My hope is that this bill will provide an added inducement to Virginia and the 18 other states that haven’t yet expanded Medicaid to make the sensible choice, and expand coverage for millions more Americans.”  

The Affordable Care Act provides financial support to states that choose to expand their existing Medicaid programs to provide healthcare coverage to all individuals up to 138 percent of the federal poverty level.  The federal government pays the full cost of expansion for the first three years for states that expanded in 2014, phasing down to a 90 percent match rate for the sixth year and all subsequent years.

While the Medicaid expansion was intended to be national in 2014, the Supreme Court’s holding in National Federation of Independent Business (NFIB) v. Sebelius made expansion optional for states. As a result, those choosing to expand coverage after 2014 do not receive the same full federal matching rates in the first three years as those that expanded immediately.

“In the states that haven’t expanded Medicaid, many adults living near the poverty level are now unable to afford health care.  The SAME Act would help close that gap in coverage and improve access to preventive health care services,” said Jon Peacock, Research Director of the Wisconsin Council on Children and Families. “The existing law already makes expanding Medicaid a very good deal for Wisconsin, but it would be fairer to give all the states the same incentive to close a gap in affordable coverage for adults near the poverty level. We applaud the sponsors of this legislation for striving to help states take full advantage of the Affordable Care Act and improve access to essential health care services.”

"The refusal of federal dollars to strengthen Medicare by Wisconsin and other states puts politics ahead of the critical need for every family to have access to quality affordable health care," said Robert Kraig, Executive Director of Citizen Action of Wisconsin. "This bill gives states like Wisconsin that are still obstructing health coverage for people just above the poverty line a positive incentive to do the right thing, and guarantee coverage for everyone who does not get good affordable insurance at work."

"I applaud Senator Baldwin and her colleagues for introducing this proposal, which would make it even more difficult for Wisconsin to continue Governor Walker's BadgerCare eligibility reform mistakes,” said Mike Bare, Research and Program Coordinator for the Community Advocates Public Policy Institute. “Congress should pass this bill, the President should sign it, and Governor Walker and the Legislature should immediately expand BadgerCare to cover 83,000 more people and save state taxpayers more than a billion dollars over the next ten years. Savings achieved by expanding BadgerCare eligibility could be reinvested in creating jobs, improving education, and providing relief for low-income Wisconsinites.”

Thirty-one states and the District of Columbia have already expanded eligibility for Medicaid, while 19 states have not yet expanded their programs. In states that have failed to expand Medicaid as envisioned under the health care law, nearly 3 million low-income adults fall into a “coverage gap,” having incomes that are too high to be eligible for Medicaid, but are too low for the limit that would allow them to receive tax credits to purchase affordable coverage in the health care marketplace. Without Medicaid expansion, most of these individuals are likely to remain uninsured, as they have limited access to employer coverage and frequently find the cost of unsubsidized marketplace coverage to be prohibitively expensive.

Numerous studies have shown that expanding Medicaid benefits states both directly and indirectly in the form of jobs and earnings growth, generating additional federal revenue, increasing Gross State Product, increasing state and local revenues, and reducing uncompensated care and hospital costs.  

The SAME Act would make the expansion as good of a deal for those states choosing to expand Medicaid late as it was for those that did so in 2014. Seven states that have already expanded since the start of 2014 would also benefit.

The SAME Act has been endorsed by AFSCME, Alliance for Retired Americans, America’s Essential Hospitals, American Cancer Society Cancer Action Network, American Heart Association/American Stroke Association, Association of American Medical Colleges, B’nai B’rith International, Altarum Institute Center for Elder Care and Advanced Illness, Center for Medicare Advocacy Inc., Center on Budget and Policy Priorities, Children's Defense Fund, Families USA, Justice in Aging, March of Dimes, Mental Health America, National Association for Home Care & Hospice, National Association of Area Agencies on Aging (n4a), National Association of Community Health Centers, National Association of County and City Health Officials, National Committee to Preserve Social Security and Medicare, National Consumer Voice for Quality Long-Term Care, National Health Law Program, Planned Parenthood Federation of America, United Methodist Church General Board of Church and Society, and Young Invincibles.