ELECTION ISSUE: Medicaid Expansion

Montana is not what most of us consider an election battle-ground state, yet here we are.  After the Medicaid expansion Bill was killed by tea-party supporters,  a bi-partisan group of legislators did an procedural end-run and allowed the bill to return to the floor for debate.

WHAT IS MEDICAID EXPANSION- As part of ObamaCare, states were required to expand Medicaid to 138% of the Federal Poverty Level, but provided little in the way of long-term funding.  On June 29, 2012 the US Supreme Court rules that, as Medicaid is run on a state-by-state basis, and that the threat to cut ALL medicaid funding was unconstitutional.  They further made the expansion an elective event for each state.

WHY IS THIS A PROBLEM-  Almost half of the states (mostly red states) have refused to expand Medicaid.  In many states, you are eligible for Medicaid between 50-100% of the Federal Poverty Level.  So you log into healthcare.gov, enter your information expecting to get a subsidy, and because your income is 105% of the Federal Poverty level (about $12,000 a year) you are not eligible for a subsidy on ObamaCare, nor are you eligible for Medicaid.  ObamaCare will penalize/tax/fine you if you don’t have health insurance, but you are not eligible for either assistance program – so you have to pay full price.  Obviously, at this income level you cannot afford $400 a month or higher.

HOW DOES THIS IMPACT THE ELECTION-  The Fringe Democrats continue to push for the remaining states to expand.  The fringe Republicans (Tea party, etc) are staunchly opposed to expanding it, especially with an unfunded mandate.    They also bring up the point that noone knows how much ObamaCare is going to cost (the CBO estimates $113 billion, and they are almost always low).

Most of the politicians seem to recognize this disparity (We will give a family of 4 earning $90,000 a subsidy, but not help those that need it most), and seem to be at a loss when it comes to resolving the issue.  The Republicans have the biggest problem on this one – If they support expansion they will alienate many of the party core, and if they don’t, they further alienate the poor, who they are courting, and it could cost them the election.