Medicaid expansion was designed to be one of the pillars of the Affordable Care Act. But then the Supreme Court decided that states could decide whether to expand.
When states decide against expanding, there’s a big coverage gap, between the lowest income individuals and families who receive Medicaid, and those who can buy insurance through the marketplace and receive subsidies to lower the cost of their premiums.
In that coverage gap fall millions of Americans who work for a living but don’t make much money.
The politics of Medicaid expansion has been contentious in some states, but business groups are weighing in.
Bangor’s Chamber of Commerce is just one of many business groups that want to see an expansion of Medicaid
As the Bangor Chamber’s CEO John Porter stated, the group supports expansion “to fully leverage available federal dollars under the Affordable Care Act.”
Moreover, Porter’s argument — that expanding Medicaid will bring in quite a lot of federal dollars — applies especially to Maine.
As this chart from the Heritage Foundation shows [source], Maine taxpayers would save $690 million from Medicaid expansion, in large part because the state has already achieved above-average enrollment.
In addition, approximately 70,000 Maine people will get or maintain health coverage via this expansion.
If they do not receive the coverage, they are far more likely to defer care, leading to much higher expenses and more serious illnesses.
The Bangor region has a thriving health care sector, with two hospitals, a cancer treatment center and many laboratory facilities and medical and dental practices.
Leaving this gap in coverage in place means that people won’t be able to pay their medical bills, thus undermining those health care facilities.
Also, as health economist Jonathan Gruber estimates, premiums will be 15% higher in states that don’t expand Medicaid — something that will stress businesses offering health insurance.
States with Republican governors that have expanded Medicaid have done so with the enthusiastic support of businesses
In Ohio, Republican Gov. John Kasich expanded Medicaid because of its benefits to business. His state’s Chamber of Commerce supports the move.
Mr. Kasich, who has championed job creation as he prepares for a re-election campaign next year in his swing state, has argued that expanding Medicaid eligibility will be an economic booster shot, because companies will be lured to Ohio by a healthier work force. Expansion is supported by state hospitals, the County Commissioners Association of Ohio and the Ohio Chamber of Commerce. [source]
Arizona Gov. Jan Brewer, a Republican, also cited business concerns, when she announced her support for Medicaid expansion. [source]
With this expansion, Arizona can leverage nearly $8 billion in federal funds over four years, save or protect thousands of quality jobs and protect our critical rural and safety-net hospitals. The business and health care communities are uniting with me in this effort because they know how important this issue is to Arizona.
Business leaders accompanying Gov. Brewer pointed to “hidden tax” paid by companies now — the money paid to cover the costs of people without insurance.
Said Todd Sanders, CEO of the Greater Phoenix Chamber of Commerce:
Expanding AHCCCS makes sense for thousands of uninsured Arizonans, as well as for the many businesses that indirectly bear the costs of care for the uninsured through higher insurance premiums. The ‘hidden health care tax’ is a real issue for companies of all sizes, and addressing it saves our members money and makes our state more competitive.
Idaho, a deep red state, hasn’t expanded Medicaid yet, but it is on the road to do so. Not only does Republican Gov. Butch Otter support this step, so does its chief business association.
[The Idaho Association of Commerce and Industry] took a formal position in favor of expansion at its September  board meeting. On Friday [November 15, 2013], LaBeau sent a letter to Gov. Butch Otter calling for re-convening Otter’s task force on Medicaid redesign – which last year recommended the expansion, along with various changes to the Medicaid program – to look at how best to accomplish it. . .
A University of Idaho study this year estimated that expansion could save the state budget more than $600 million in the next decade and save county property taxpayers $478 million. [source]
As these Republican governors and the business groups in their states recognize the advantages of Medicaid expansion, the question remains why Maine, which has so much to gain, hasn’t expanded MaineCare.