Medicaid Expansion: A State-by-State Layout

As things currently stand, 16 states and the District of Columbia have committed to expanding Medicaid to nearly all non-disabled adults with household incomes at or below 138 percent of the federal poverty line ($14,856 per year for an individual and $30,657 per year for a family of four in 2012), with three more states likely to follow, according to data from the Advisory Group and the Kaiser Family Foundation (pdf).

Those states — including seven led by Republican governors such as Gov. Jan Brewer of Arizona — will pay no additional cost for the expanded coverage for three years while CMS picks up the tab and will pay just 10 percent of the added cost after that.

In contrast, 27 states have rejected or are likely to refuse the expansion in the coming year, all with Republican governors.

Seven more states have not yet announced an allegiance to either side of the argument.

Some states like Wisconsin have agreed to widen the criteria for Medicaid eligibility but will not meet all the standards to receive the federal funding incentive.

An innovative "premium support" plan pioneered by Arkansas is turning the heads and minds of some once-opposed governors. The model, conceptually approved by HHS, would qualify for the additional federal funding and be used as a voucher for Medicaid beneficiaries to purchase health insurance on the exchanges. The plans would be offered from private companies, and are allowed to include small copays.

Here is the layout of states' positions on the Medicaid expansion, current as of May 2, 2013:

Alabama — Will not expand
Gov. Robert Bentley, MD (R)    

— May not expand
Gov. Sean Parnell (R)

Arizona — Will expand
Gov. Jan Brewer (R)

Arkansas — Will expand with premium support
Gov. Mike Beebe (D)

California — Will expand
Gov. Jerry Brown (D)

— Will expand
Gov. John Hickenlooper (D)

— Will expand
Gov. Dan Malloy (D)

— Will expand
Gov. Jack Markell (D)

District of Columbia
— Will expand
Mayor Vincent Gray (D)

— Will not expand
Gov. Rick Scott (R) *Gov. Scott, a former hospital executive, supported the bill, but GOP lawmakers voted against it.

— Will not expand
Gov. Nathan Deal (R)

Hawaii — Will expand
Gov. Neil Abercrombie (D)

Idaho — Will not expand
Gov. Butch Otter (R)

— Will expand    
Gov. Pat Quinn (D)

— May expand
Gov. Mike Pence (R) (Mitch Daniels previously)

— Will not expand   
Gov. Terry Branstad (R)

Kansas — Undecided
Gov. Sam Brownback (R)

— May expand
Gov. Steve Beshear (D)

— Will not expand
Gov. Bobby Jindal (R)

— May not expand
Gov. Paul LePage (R)

Maryland — Will expand
Gov. Martin O'Malley (D)

Massachusetts — Will expand
Gov. Deval Patrick (D)

— Will expand
Gov. Rick Snyder (R)

— Will expand
Gov. Mark Dayton (D)

— Will not expand
Gov. Phil Bryant (R)

Missouri — Will not expand
Gov. Jay Nixon (D) *Gov. Nixon supported the bill, but GOP congressman shut the bill down in committee

— Will expand
Gov. Steve Bullock (D) (Brian Schweitzer previously)

Nebraska — May not expand
Gov. Dave Heineman (R)

Nevada — Will expand
Gov. Brian Sandoval (R)

New Hampshire
— Will expand
Gov. Maggie Hassan (D) (John Lynch previously)

New Jersey
— Will expand
Gov. Chris Christie (R)

New Mexico
— Will expand
Gov. Susana Martinez (R)

New York
— May expand
Gov. Andrew Cuomo (D)

North Carolina
— Will not expand
Gov. Pat McCrory (R) (Bev Purdue previously)

North Dakota
— Will expand
Gov. Jack Dalrymple (R)

Ohio — Will expand
Gov. John Kasich (R)

Oklahoma — Will not expand
Gov. Mary Fallin (R)

Oregon — May expand
Gov. John Kitzhaber, MD (D)

Pennsylvania — Will not expand
Gov. Tom Corbett (R)

Rhode Island
— Will expand
Gov. Lincoln Chafee (I)

South Carolina
— Will not expand
Gov. Nikki Haley (R)

South Dakota
— Will not expand
Gov. Dennis Daugaard (R)

— May expand with premium support
Gov. Bill Haslam (R)

— Will not expand
Gov. Rick Perry (R)

Utah — Undecided
Gov. Gary Herbert (R)

— Will expand
Gov. Peter Shumlin (D)

— Will not expand
Gov. Bob McDonnell (R)

— Will expand
Gov. Jay Inslee (D) (Christine Gregoire previously)

West Virginia
— Will expand
Gov. Earl Ray Tomblin (D)

— Will not expand
Gov. Scott Walker (R)

Wyoming — May not expand
Gov. Matt Mead (R)

More Articles on Medicaid Expansion:

Medicaid Cheaper to Grow in Colorado, Study Says
California First State to Standardize Health Plan Copays, Deductibles
Wisconsin's Scott Walker Turns Down Full Medicaid Expansion

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