Like Countable?

Install the App
TRY NOW

house Bill H.R. 584

Do States Need More Federal Funds to Expand Medicaid?

Argument in favor

States that haven’t expanded Medicaid for people who are newly eligible under the Affordable Care Act should receive extra federal funds if they do so.

IllWill's Opinion
···
03/19/2019
What we really need is Medicare-for-all so that all Americans have coverage!
Like (126)
Follow
Share
burrkitty's Opinion
···
03/19/2019
As a step on the way to Medicare for all.
Like (46)
Follow
Share
Dave's Opinion
···
03/19/2019
States need to expand their Medicaid coverage to all individuals in their states or healthcare for all. Sense we are the 35 healthiest country in the world, didn’t make the top 25, thing need to change!
Like (43)
Follow
Share

Argument opposed

The federal government shouldn’t be bribing states with taxpayer dollars to expand Medicaid. If they want to, they will make their own decision to expand it.

Nicholas's Opinion
···
03/19/2019
Give the money you stole back to the people who earned it.
Like (58)
Follow
Share
Hanuman's Opinion
···
03/19/2019
Stop taking my money for no good reason. Give me a voucher to buy my own healthcare.
Like (24)
Follow
Share
Doug's Opinion
···
03/19/2019
No, what we need is more freedom and less government intervention in our lives, relieve us of our heavy tax burdens and let us decide how to spend our own money, freedom is what has made America great not socialism, make America great again.
Like (22)
Follow
Share

bill Progress


  • Not enacted
    The President has not signed this bill
  • The senate has not voted
  • The house has not voted
      house Committees
      Committee on Energy and Commerce
    IntroducedJanuary 16th, 2019

What is House Bill H.R. 584?

This bill — the Incentivizing Medicaid Expansion Act — would amend Medicaid to give states that expand their Medicaid coverage for individuals who are newly eligible under the Affordable Care Act (aka Obamacare) the enhanced Federal Medical Assistance Percentage (FMAP) when the expansion occurs. In essence, it would mean that those states would get more matching funds for their Medicaid program by expanding their coverage.

Currently, the enhanced FMAP equates to 100 percent in 2014-2016, 95 percent in 2017, 94 percent in 2019, and 90 percent thereafter. This bill would retain the enhanced FMAP but base it on a term of years rather than specific dates, so states would get three years of full federal funding when they expand Medicaid.

The bill would also apply retroactively, so states that have already expanded their Medicaid programs would receive the FMAP based on when their expansion occurred.

Impact

States that have already, or are yet to expand their Medicaid program; and the federal government.

Cost of House Bill H.R. 584

A CBO cost estimate is unavailable.

More Information

In-Depth: Rep. Marc Veasey (D-TX) reintroduced this bill from the 115th Congress to encourage the 14 states that have yet to expand Medicaid under the Affordable Care Act (ACA) to do so by giving them extra funds for the expansion:

“The bill will create an incentive for all eligible States to provide affordable health care coverage for all of their citizens. In Texas, approximately 638,000 people would gain coverage if Medicaid were expanded. This is a no-brainer for the state of Texas and for the fourteen states across the country who haven’t adopted this program.” 

Original cosponsoring Rep. Terri Sewell (D-AL) adds that the "writing is on the wall" for states that have yet to expand Medicaid: 

"The writing is on the wall and the facts are clear: premiums and health care costs are higher in states that have not expanded Medicaid. And over 90% of rural hospital closures have been in states that did not expand Medicaid before the closure. In my state, approximately 314,000 more Alabamians would be covered under Medicaid expansion. Not doing so is a poor decision. And while I can’t force Alabama’s governor to expand Medicaid, I can continue to promote legislation that provides more incentives for her to do so. T[his] legislation is a step in the right direction."

Last Congress — and in the years before it — Rep. Gene Green (D-TX) introduced this bill to incentivize states that haven’t yet expanded Medicaid to do so:

“Expanding Medicaid is as much of a good deal for states as it is for patients. In our District alone, 55,000 residents would gain coverage if Texas expanded Medicaid, and 1 million people would gain coverage statewide. Under the ACA, this would happen at minimal cost to the state with the federal government financing 100 percent of expansion costs for the first three years and after that, no less than 90 percent on a permanent basis. Rather than letting the 90 percent match rate take effect in 2017 as originally written into the ACA, this bill would allow all states who expand now or in the future to receive 100 percent backing for 3 years from the date of expansion.”

Those who oppose states expanding their Medicaid programs argue that federal assistance will decline over time and that even without the expansion, many states struggle to balance their budget each year. Not only that, but Medicaid is the largest expenditure for most states and its costs increase faster than tax revenue can be brought in to keep pace.

In the current session of Congress, there are 18 Democratic cosponsors of this bill. Last Congress, this bill had four Democratic cosponsors and didn't receive a subcommittee vote. In the 114th Congress, it had 18 Democratic cosponsors in the House and didn't receive a subcommittee vote.


Of Note: Following a 2012 ruling by the U.S. Supreme Court that states weren’t required to expand their Medicaid programs to accommodate the Affordable Care Act, 19 states opted not to expand their program. As of this bill's reintroduction in mid-January 2019, 14 states — Alabama, Georgia, Florida, Kansas Mississippi, Missouri, North Carolina, Oklahoma, Tennessee, Texas, South Carolina, South Dakota, Wisconsin, and Wyoming — had yet to expand their Medicaid programs under the ACA.

Rep. Veasey's office estimates that states that opt out of the Medicaid expansion are missing out on $305 billion over the 2013-2022 period. Medicaid expansion under the ACA allows states to receive 100 percent Federal Medical Assistance Percentages for the first three years a newly-eligible individual is enrolled in the Medicaid program, 95 percent for the fourth year, 94 percent for the fifth year, 93 percent for the sixth year, and 90 percent each year thereafter — in short, a significant cost reduction for states.


Media:

Summary by Eric Revell

(Photo Credit: Ragesoss / Creative Commons)

AKA

Incentivizing Medicaid Expansion Act of 2019

Official Title

To amend title XIX of the Social Security Act to provide the same level of Federal matching assistance for every State that chooses to expand Medicaid coverage to newly eligible individuals, regardless of when such expansion takes place.

    What we really need is Medicare-for-all so that all Americans have coverage!
    Like (126)
    Follow
    Share
    Give the money you stole back to the people who earned it.
    Like (58)
    Follow
    Share
    As a step on the way to Medicare for all.
    Like (46)
    Follow
    Share
    States need to expand their Medicaid coverage to all individuals in their states or healthcare for all. Sense we are the 35 healthiest country in the world, didn’t make the top 25, thing need to change!
    Like (43)
    Follow
    Share
    What we really need is medicare for all.
    Like (27)
    Follow
    Share
    Whatever it takes to create opportunity for everyone, yes even those that don’t deserve affordable health care. As far as federal programs I don’t hear anyone crying about their federally subsidized Medicare. No complaints from retired military with their Tricare. Again no winners on them getting retirement sis checks. Maybe it might be a good idea to do a little fact checking before people complain about what they know nothing about.
    Like (26)
    Follow
    Share
    Heath care is a right.
    Like (24)
    Follow
    Share
    Stop taking my money for no good reason. Give me a voucher to buy my own healthcare.
    Like (24)
    Follow
    Share
    YES! I think any legal resident of the U.S., who makes less than 50k a year, should qualify for Medicaid.
    Like (23)
    Follow
    Share
    We need Medicare For All, but this will help in the meantime.
    Like (22)
    Follow
    Share
    No, what we need is more freedom and less government intervention in our lives, relieve us of our heavy tax burdens and let us decide how to spend our own money, freedom is what has made America great not socialism, make America great again.
    Like (22)
    Follow
    Share
    Since Trump tries to gut Affordable Care Act and Medicare the states will be the ones to catch the people he shoves over the cliff.
    Like (17)
    Follow
    Share
    We are the richest country in the world yet our health care system is pathetic. People are dying because they cannot afford medicine that would keep them alive. Insurance companies refuse to cover needed treatment even to those who pay monthly premiums. People are traveling to third world countries to get procedures they can’t afford here. That’s insane. When will citizens become important than money?
    Like (17)
    Follow
    Share
    This question is like asking if we need air to breath and water ton drink. Medical care is something everyone needs and the fact that some people still do not have the medical care they need because they can't afford it is horrifying! We act like we are a third world country, not a world leader! Insurance companies need to stop racking us over the coals with the cost of their sub par insurance plans. We all need full coverage Heathcare that will not bankrupt each individual and make us not want to go to the doctors out of fearvof the cost after the copay. We need Universal Health Insurance, or Medicare for all, or whatever you want to call it.
    Like (14)
    Follow
    Share
    No more $$$ for Medicaid! NO Medicaid for all! No SOCIALIZED medicine!
    Like (14)
    Follow
    Share
    We need to reign in all this socialist spending. We don’t need to expand Medicaid anymore than it already is. We may need to cut down on Medicaid especially those who can work and just refuse to.
    Like (13)
    Follow
    Share
    Prior to giving more tax payer money toward a program that is full of fraud, taxpayer money would be better spent hiring a task force to eliminate the fraud. So no way should more taxpayers money go to this program
    Like (13)
    Follow
    Share
    For the last 12 years Repubs claimed they had a health care package that would blow Obamacare out of the water! Under trump they had the house, the Senate and the white house and nothing happened, just deafening silence! So you can now fund states that are stepping up to give their citizens healthcare, it's the least you can do sense you failed at that low cost, great, best ever healthcare!
    Like (12)
    Follow
    Share
    We should all have a one payor system that is government funded.
    Like (12)
    Follow
    Share
    There are people who are dying because they cannot afford medical treatment, We must expand Medi-caid
    Like (10)
    Follow
    Share
    MORE