July 2015 - Montana and Alaska have joined 28 other states and the District of Columbia to take advantage of federal Medicaid assistance being offered to states that expand the number of Citizens who qualify for Medicaid. Medicaid is the state-administered program that helps lower-income families and the disabled get needed medical treatment.

This Medicaid expansion should have been a no-brainer: the federal government is picking up 100% of the expanded program costs through 2016 and while that percentage decreases slightly thereafter, the federal share will remain at 90% of program costs starting in 2020.

Unfortunately, it was a struggle to achieve this expansion in both states, primarily for one partisan political reason: the legislation to provide the federal funding was part of the Affordable Care Act (ACA) and, as most of you know, the far right is opposed to anything related to the ACA, even when it benefits tens of thousands of their state's Citizens.

(Montana Gov. Steve Bullock - image from gettyimages.com)

Fortunately, common sense prevailed in the end and an estimated 45,000 - 70,000 Citizens in Montana and 42,000 Citizens in Alaska will be direct beneficiaries. Indirectly, the rest of each state also will benefit, due to an increase in the number of health care jobs created and also by having a healthier work force. The latter will mean higher productivity for those states' economies and, according to a number of economic studies, lower overall health care costs.

In Montana Democratic Governor Steve Bullock was able to work with enough Republicans in the GOP-controlled legislature to get a plan passed that, while needing federal approval due to the plan's requirement that recipients pay a small premium, is expected to take effect later this year.

In Alaska, Republican-turned-Independent Governor Bill Walker used his legal authority as Governor to unilaterally expand the state's Medicaid program and accept the federal funds. The Governor was frustrated after months of inaction on the issue by Alaska's Republican legislature. Governor Walker ran as an independent in 2014 largely on the issue of Medicaid expansion. Unless the Alaskan legislature passes legislation to the contrary, Governor Walker's plan will take effect in September.

(Bill Walker image from alaskapublic.org)

Note that Alaskan Governor Bill Walker is not the Governor Walker who is running for President in 2016. The latter is Wisconsin's GOP Governor Scott Walker, who is firmly opposed to Medicaid expansion (and, many claim, is firmly in the pocket of the billionaire Koch brothers). Because of Scott Walker, Wisconsin is the only Midwestern state run by the GOP since 2010 that has not expanded its Medicaid program.

It's a shame that far right extremists have blocked Medicaid expansion in 20 states, thereby forcing those Citizens without coverage to seek medical treatment through expensive emergency room visits. These visits end up being covered by the rest of us, anyway, but at a much higher cost than if these patients had visited their family doctor when they first got sick. (In some cases, the states cover a percentage of the emergency room treatment for indigent patients; the rest of the costs are covered by those of us who end up paying higher co-pays or insurance premiums to cover the higher amounts that hospitals have to charge in order to make up for those patients who cannot pay.)

Although this article has touched on some of the economic arguments in favor of Medicaid expansion, for many, the moral argument for assisting the less well-off is sufficient. We'll explore that argument in a future article.

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