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EGACY
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Yesterday. Today. Tomorrow.
WEDNESDAYS • Jan. 31, 2018
Richmond & Hampton Roads
Presidential proclamation
America's greatness is a testament to generations of courageous individuals who, in the face of uncomfortable truths, accepted that the work of perfecting our Nation is unending and strived to expand the reach of freedom to all.- BHO, 2016
LEGACYNEWSPAPER.COM • FREE
How Trump may end up expanding Medicaid
Some Republicans in Virginia are renewing calls to take up Medicaid expansion. Republican lawmakers in a half-dozen states are launching fresh efforts to expand Medicaid, the nation’s health insurance program for the poor, as party holdouts who had blocked the expansion say they’re now open to it because of Trump administration guidelines allowing states to impose new requirements that program recipients work to get benefits. In Utah, a Republican legislator working with the GOP governor says he hopes to pass a Medicaid expansion plan with work requirements within the year. In Idaho, a conservative lawmaker who steadfastly opposed Medicaid expansion in the past says the new requirements make him more open to the idea. And in Wyoming, a Republican senator who previously opposed expansion — a key part of President Barack Obama’s health-care law — says he’s ready to
take another look at fellow Republicans’ expansion efforts in his state. Moderate Republicans in North Carolina, Virginia and Kansas are similarly renewing calls to take up Medicaid expansion, though it’s unclear if there will be quite enough conservative support or whether Democrats would consider voting in favor of work requirements. If successful, though, the efforts could make hundreds of thousands of Americans newly eligible for health coverage, while also opening the door to Medicaid changes that could kick some current beneficiaries out of the program and reduce its benefits to recipients — broadening the program’s reach into red states but with a decidedly conservative bent. “All of a sudden, we’re seeing some flexibility that allows us to do it our way, and that gives
it a much better chance,” said Wyoming state Sen. Ogden Driskill, a Republican who helped defeat Medicaid expansion in a close vote in 2015. “Without the heavy hand of the government forcing it down our throats, many of us will take a much deeper look at it.” The Trump administration earlier this month said states could apply to add work requirements to their state Medicaid programs, a first in the program’s history. Ten states have already filed requests for such waivers, and the Trump administration has approved a Kentucky plan to add work requirements and premiums to its program. The new Trump administration rules may also shake up the balance of power in state-level struggles over Medicaid expansion. Thirty-two states and the District have expanded Medicaid since the Affordable Care Act was enacted, giving health care to approximately 13 million additional people. (Maine voters approved a Medicaid expansion in a November ballot referendum, but it has not yet taken effect.) The other 17 states are overwhelmingly GOPdominated. In many, Democrats and some moderate Republicans repeatedly have attempted expansions, hoping to take advantage of federal funding available to provide health insurance for low-income patients. But they’ve seen their efforts thwarted by conservative lawmakers and governors, who argue that expansion would give health care to “able-bodied” Americans and explode state budgets. Now, moderate Republicans hope to win over their conservative colleagues by packaging the expansion with work requirements or other limits on who is eligible for the program, under what circumstances and for how long. Their chances of success vary widely depending on the state. In Utah, a Republican lawmaker who has opposed a more generous Medicaid expansion is working with a supportive governor and leaders in the state’s House and Senate on a version that would include work requirements. Under the new rules, “we think that there may be a window of opportunity to revisit the
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