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Odds on Medicaid Expansion for states: About 2 to 1

February 12, 2013
by Dennis Grantham, Editor-in-Chief
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Among states that have declared intent regarding the Medicaid Expansion, it is now 2-to-1 in favor. A prediction about what are the other states will do . . .

I'm no oddsmaker, but I did sit down with a couple of maps and a pencil and did some math on state decisions regarding what governors are saying -or already have said -about the Medicaid Expansion (related articles). Here are my findings so far:

1. Among the 32 governors that have made a decision about the expansion--a decision that must pass muster with state legislatures--21 have come out in favor, with 11 against. Just about 2-to-1 in favor so far.

Favor Expansion Against Expansion
6 Republicans 11 Republicans
15 Democrats 0 Democrats
21 states 11 states


2. Though the Affordable Care Act, which includes the Medicaid Expansion, passed without a single Republican vote in the US Senate or the US House,  Republican governors are clearly reconsidering their party's opposition to the ACA on a state-by-state basis. Six have decided to support the Expansion so far.   

State Governor (R)
Arizona Jan Brewer
Michigan Rick Snyder
Nevada Brian Sandoval
New Mexico Susana Martinez
North Dakota Jack Dalrymple
Ohio John Kasich

Interestingly, once you leave behind the seven Deep South states (Texas, Oklahoma, Louisiana, Mississippi, Alabama, Georgia, South Carolina) whose Republican governors together oppose the Expansion, a majority of the remaining 10 Republican governors (see list of six above) who've made a decision have decided to support the Expansion, with just four governors recommending opposition (Idaho, South Dakota, Pennsylvania, and Maine). Of these "against" states, Pennsylvania strikes me as a surprise. So far, it is the only big, rust-belt state with a Republican Governor (Tom Corbett) that did not support the Expansion. Pennsylvania has voted Democratic at the presidential level since 1988 and, as a state, has always maintained high-quality state services. Corbett's decision cannot sit well with all of those working Democrats who must have crossed over to narrowly give him the gubernatorial win. 

3.  Of the 18 remaining state governors who have not committed to a position on the Medicaid Expansion, 11 of these undecided governors are Republican, six are Democratic, and one is an independent - Rhode Island's Lincoln Chafee.  Here's the breakout:




According to Vic Topo, President and CEO of the Center for Life Management (Derry, NH), Governor Maggie Hassan today (2/19/13) recommended that New Hampshire implement the Medicaid expansion.

This is big news--Florida Governor Rick Scott announced that he is recommending implementation of the Medicaid Expansion yesterday. The GOP-led legislature still needs to vote on the matter, and it's not a sure thing.

But Scott used the "out" that's been used by so many GOP governors--that the Expansion is a good deal "if" the federal government holds up its part of the bargain.


Dennis Grantham

Dennis Grantham



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