Governors Weighing Medicaid Expansion Options

Governors Weighing Medicaid Expansion Options


Last month’s Supreme Court ruling regarding the Affordable Care Act has been met with hesitation and backlash by many governors.  To date, most governors have not committed to expanding Medicaid, which was an option created by the Supreme Court’s ruling. On June 28, the Supreme Court ruled that it was unconstitional for the federal government to withhold existing Medicaid funding from states who do not comply with the Medicaid expansion.

Under the expansion, about 17 million Americans would be eligible to receive Medicaid benefits. The Affordable Care Act opens Medicaid to individuals with incomes up to 133 percent of the poverty line.  This issue has been a hot topic for both political parties with Republican nominee Mitt Romney proclaiming he would get rid of the controversial law nicknamed “Obamacare” if elected.  The Supreme Court’s ruling has been viewed as a personal victory for President Obama who faces Mitt Romney in this year’s presidential election.  However, the option to expand Medicaid is one that will be solely left to state governors to decide.

Governors from both parties have opposing views regarding Medicaid expansion.  To date, Republican governors in Florida, Iowa, Louisiana, Nebraska, Texas, South Carolina, and Wisconsin have publicly stated that they will not participate in the Medicaid expansion.  GOP governors in Alabama, Georgia, Indiana, Mississippi, Nevada, and Virginia have indicated that they will most likely choose not to expand their Medicaid program.

Gov. Rick Perry of Texas has been an outspoken critic of both the Affordable Care Act and the Medicaid expansion provision.  After the Supreme Court’s ruling, Gov. Perry wrote a letter to U.S. Health and Human Services Secretary Kathleen Sebelius stating he would not expand the Medicaid program in Texas nor create a state health exchange program.  Within the letter, Gov. Perry states “Neither a state exchange nor the expansion of Medicaid under this program would result in better patient protection or in more affordable care.”

Thirteen Democratic governors including Independent Gov. Lincoln Chaffee of Rhode Island, have announced their intentions to fully implement the ACA’s Medicaid expansion.  Democratic governors in Delaware, Kentucky, Missouri, Montana, New Hampshire, North Carolina, and West Virginia remain undecided about expanding Medicaid. Maryland Gov. Martin O’Malley, Chairman of the Democratic Governors Association, is in favor of the Medicaid expansion for his state.  During the National Governors Association Annual Meeting, O’Malley stated,

“I think you’ll see that states that are too slow to find a way to implement will put themselves at an economic disadvantage as states like Maryland and other states are able to make health care more affordable for more small businesses and family-owned businesses, which are the ones that really create jobs.”

The decision to expand Medicaid is one to affect generations of Americans and determine whether individuals who cannot afford private insurance will receive healthcare. In the upcoming months and years, governors will continue to weigh the costs and benefits of expanding Medicaid in their states.


  1. Thank you for this article. I think we will soon start seeing the difference between states that care for its people and states that answer to other concerns.

    On an entirely different note, mark my words that blue states are going to emerge as the most dynamic and business-friendly environments. I'm still trying to figure out how I ended up living in a state as red as Florida. When people see, however, the growth in other states, this may change, or at least lean more purple. Great piece, thanks!