Still holding on to the notion that we live in a world where a President can’t unilaterally extend federal health benefits without Congressional oversight? Well, you’re not alone. States like Georgia, Alabama, and Florida are taking a stand, challenging the Biden administration’s authority to extend federal health benefits without Congress pulling the strings.
The argument is simple: Who gave this administration the right to play doctor and financier without a proper check and balance? These states are advocating for their approaches—partial Medicaid expansions or increasing funding for specific health programs, such as Mississippi’s proposal to increase Medicaid reimbursements to hospitals.
Health advocates, on the other hand, aren’t buying into it. They argue that partial Medicaid expansions are like putting a Band-Aid on a bullet wound—inadequate compared to full expansion. This, they claim, leads to poor health metrics, rural hospital closures, and high uninsured rates in states refusing full expansion.
The Federal Funding Perspective
The Affordable Care Act (ACA) allows for Medicaid expansion to cover adults with incomes up to 138% of the poverty level, with the federal government footing 90% of the bill. Non-expansion states face challenges such as limited Medicaid eligibility for adults unless they are pregnant, parents, or disabled, along with very low income thresholds for eligibility.
The Pushback from Republican States
Predictably, Republican opposition abounds, citing concerns about costs, effectiveness, and frankly, a rejection of government-funded healthcare. Despite these reservations, it’s noteworthy that most Americans, including those in non-expansion states, support Medicaid expansion.
The Biden Administration’s Alternative
The Biden administration is not sitting idle. Proposals like a Medicare-like public option through the ACA Marketplace aim to bridge the gap. This would automate enrollment for qualifying individuals and potentially provide better reimbursement rates for providers, alleviating some pressure on state budgets.
Georgia’s Showdown
Take Georgia, for example, where the state has filed a lawsuit to continue its “Georgia Pathways” Medicaid program, which includes a work requirement for low-income residents. This lawsuit highlights the broader legal struggle between the administration’s push for more inclusive healthcare and state-level attempts to retain autonomy over their health policies.
Federal Regulations Overturning Trump’s Legacy
Further complicating matters, the Biden administration has issued final regulations that overturn Trump-era rules on association health plans and short-term, limited-duration insurance. Effective June 2024, these new rules restrict short-term plans to a maximum of four months, aiming to bring more people under comprehensive coverage rather than leaving them reliant on limited-term fixes.
Potential Concerns with Biden’s Public Option
While the plan sounds rosy, there are potential pitfalls. Increased state costs, benefit scope negotiations, and coordination with Medicaid are just a few issues on the horizon. Ensuring the program meets low-income patients’ needs remains a significant hurdle.
It’s a critical juncture for federal and state health policies. As states pursue their paths and the Biden administration pushes for broader federal health benefits, the courts will likely play the role of a referee in this high-stakes match. Whatever side of the aisle you’re on, one thing is clear: the battle over Medicaid and federal health benefits is far from over. Stay tuned.
Sources
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9119585
- https://newhampshirebulletin.com/briefs/10-medicaid-holdout-states-scramble-to-improve-health-coverage/
- https://apnews.com/article/georgia-medicaid-work-requirement-2c55bea028e71fa531a63f80896452af/
- https://www.ballardspahr.com/insights/alerts-and-articles/2024/05/final-rules-overturn-trump-era-health-benefit-rules/
