Did LePage just endorse part of Obamacare? It matters for Medicaid

This week’s radio address from Gov. LePage included a shocker toward the end — an endorsement of part of Obamacare.

LePage’s positive words about this policy element could — just could — open the door to a less common way of expanding Medicaid.

Gov. LePage has refused to support Medicaid expansion.

But, in his talk, Gov. LePage seemed to support the subsidies to buy insurance through insurance exchanges.

These are not just for very low-income individuals, by the way. A family of four with an annual income of $40,000 would get a $10,000 subsidy.

In arguing that rapidly paying back hospitals should not be tied to Medicaid expansion, LePage said:

[U]nder ObamaCare, low-income Mainers will qualify for federal tax subsidies to buy private insurance. Let me repeat that: low-income Mainers will qualify for money from the federal government to buy health insurance.

The Supreme Court ruled that Medicaid expansion is optional. The court also revealed that if states expanded Medicaid to cover the uninsured, those same people will qualify to get tax subsidies to buy health insurance. . . If more Mainers in 2014 will get tax subsidies to become insured, why is Democratic leadership holding up the hospital bill? [Source]

If the subsidies are ok with LePage, logically he could accept a less common way of expanding Medicaid.

If the subsidy system is ok with the governor, he just might accept an approach Arkansas is using to expand Medicaid, which relies on the insurance exchanges and subsidies.

In the so-called “private option”

Arkansas would accept the money allocated for Medicaid expansion under the federal health care law, but would use it instead to buy private insurance for about 250,000 eligible low-income residents. Those individuals who earn up to 138 percent of the poverty line — or $15,415 per year — would purchase subsidized private insurance through the state’s insurance exchange. . .

GOP supporters of the idea described it as a conservative approach to reforming Medicaid and a way to help businesses avoid penalties under the federal health law for not providing insurance to employees. [Source]

In addition, this approach enables Arkansas to get the larger federal match for expanding Medicaid while not including more people in traditional Medicaid.

Now, there are various advantages and disadvantages to this approach and those are worth discussing should it gain more attention.

Gov. LePage administration hasn’t endorsed this potential policy path, but it should be asked about it, since it’s consistent with the governor’s endorsement of federal subsidies.

Amy Fried

About Amy Fried

Amy Fried loves Maine's sense of community and the wonderful mix of culture and outdoor recreation. She loves politics in three ways: as an analytical political scientist, a devoted political junkie and a citizen who believes politics matters for people's lives.