States across America have taken a side in the expansion of Medicaid, deciding whether to accept or refuse expansion in their state. Since the discussion of expansion began back in 2010, 38 states and the District of Columbia have approved federal funding to expand Medicaid under the Affordable Care Act (ACA). The other 12 states that continue to refuse such expansion have held their ground since the spread of initial rumors.
However, some states have elected instead to extend eligibility in certain cases: a new provision that was not previously available. Under both the Obama and Trump administrations, all states that attempted to partially expand Medicaid were rejected as the government refused to fund such projects so as to say “all or nothing”. In certain cases, such rejection was used to further push for complete expansion.
Motivations for Expansion Today
However, under the Biden administration, the American Rescue Plan, enacted in March 2021 in response to the Coronavirus Pandemic, provides additional funding to the remaining states should they choose to expand Medicaid, including in cases of partial expansion. The latest movement has been to expand eligibility to new mothers for postpartum coverage.
Even those states still refusing expansion are breaking their hold in this case. Nine out of the one dozen states remaining are seeking to expand benefits for mothers. While some are attempting to extend benefits past 60 days, others are seeking to go as far as a year following birth.
The reason such expansion has seen more backing than previous attempts is the reality facing mothers in the months following the birth of their child. Even with the benefits already in place, mothers struggled to find care following the end of the limited benefit period.
The Future of Expansion
The option for states to expand as a result of the American Rescue plan will remain available until March 31, 2027. Some argue that the partial expansion for maternal health could push those few remaining states toward complete expansion, while others say it is an out for them to continue to refuse.