Sebelius: Medicaid expansion no ‘bait and switch’

Aug 12, 2013, 2:13pm EDT Updated: Aug 12, 2013, 3:27pm EDT


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Dave Williams

Staff Writer- Atlanta Business Chronicle

States shouldn’t let politics get in the way of a Medicaid expansion that’s a “pretty good” economic deal, U.S. Health and Human Services Secretary Kathleen Sebelius said in Atlanta Monday.

Georgia and 20 other mostly Republican states are taking advantage of a portion of last year’s U.S. Supreme Court decision on the federal health-care law that allows states to opt out of expanding Medicaid eligibility.

Under “Obamacare,” the federal government ­­­– which currently covers about two-thirds of the state-federal health insurance program for the poor and disabled ­– would pick up 100 percent of the costs of the additional Medicaid enrollees for three years.

After that, the feds’ share would decline but still would be at 90 percent after 10 years.

“No one’s health care should be determined by their zip code,” Sebelius told an audience of state lawmakers from around the country gathered in downtown Atlanta for the National Conference of State Legislatures’ annual convention.

“There is an offer on the table.”

Sebelius said the Patient Protection and Affordable Care Act, which President Barack Obama pushed through a then-Democratic Congress in 2010, has yielded many positive results, including covering 3 million young Americans under age 26, providing free preventive care to nearly 71 million adults and saving about 3.5 million seniors an average of $700 last year on prescription drugs.

Sebelius said the last piece of the law, due to take effect Jan. 1, will help provide health insurance to the 15 percent of Americans who don’t have coverage now or buy it on the individual market.

She predicted most individuals and small business owners will save money on insurance because of the subsidies the new law provides.

She said health-care providers in states that do decide to expand Medicaid will see lower costs for uncompensated care, while governors and lawmakers in those states will be able to free tax dollars they now spend on caring for the uninsured for other priorities.

Following last year’s Supreme Court ruling, Gov. Nathan Deal cited cost considerations in deciding not to expand Medicaid eligibility in Georgia. He said enrolling individuals with incomes up to 138 percent of the federal poverty level in Medicaid would cost the state an estimated $4.5 billion during the next decade.

Deal and others also expressed concern over whether the federal government would live up to its pledge to cover all of the costs of the expansion.

But on Monday, Sebelius said some states taking part in the expansion have addressed the “bait-and-switch” issue by reserving the right to drop out of the program if the feds renege.

“There is no timeline for accepting this … or for leaving,” she told the legislators. “If you want a healthier population, looking at Medicaid expansion has got to be a piece of the puzzle.”