What Happens Now for Health Care Reform?

States are scrambling to meet deadlines and others are refusing to expand Medicaid. 

Posted: 11/12/2012 05:53 PM EST
What Happens Now for Health Care Reform?

For Barack Obama supporters, the president’s win against Mitt Romney means a lot for the issues that may matter the most: Planned Parenthood will remain federally funded, the Department of Education will stay intact, but most importantly, the Affordable Care Act (ACA) and all its benefits will remain in existence.

But when it comes to the ACA and its goal of ensuring that 30 million more Americans will have health care, so much of that is going to be based on the series of complicated steps by our federal and state governments. There is no time to bask in Obama’s victory, not when looming health care deadlines are approaching.

The New York Times reported that states have until this Friday to decide whether “individuals and small businesses can shop for health plans, and whether to expand their Medicaid programs to reach many more low-income people.” States also have to make a decision as to whether they are going to let the federal government set up shop for them or will they do it themselves on adopting the ACA.

And the number of states who have made a decision isn’t very high:

So far, only about 15 states and the District of Columbia have created the framework for exchanges through legislation or executive orders; three others have committed to running exchanges in partnership with the federal government. A number of Republican governors, including those in Arizona, Idaho, New Jersey, Virginia and Tennessee, had said they would decide after the election, giving themselves only a 10-day window before the deadline.

And while we wait for the end of the week, it’s important to understand what’s at stakes for African-Americans, especially when it comes to the expansion of Medicaid. In 2009, 27 percent of African-Americans — 10 million people, including 6 million children — were covered by Medicaid [PDF], according to the Kaiser Family Foundation. So without it, even more low-income Americans, especially those in the South, will never seek the benefits of the Affordable Care Act if their state refuses to expand it, a recent Huffington Post article points out:

At least a half-dozen governors say they simply won't go along with the law. When the Supreme Court upheld Obamacare in June, justices ruled states could opt out of the Medicaid expansion. The decision threatens to leave 3 million of the poorest Americans without health coverage, the Congressional Budget Office predicts.

Florida Gov. Rick Scott, Georgia Gov. Nathan Deal, South Carolina Gov. Nikki Haley, Mississippi Gov. Phil Bryant, Louisiana Governor Bobby Jindal and Texas Gov. Rick Perry — all Republicans — are on record so far as resistors to expanding Medicaid, according to an analyses updated Thursday by the Advisory Board, a Washington-based health care consulting company.

And no, this isn’t just a black and white issue, or a Democrat and Republican issue: Expanding Medicaid will cost state governments up to $14 billion in six years because the expansion will be on their dime, reported the Huffington Post. And for some states, that’s too much of a burden. There have been accusations that this is a partisan issue, given that the only states that have denied to expand are run by Republicans.

In the end, President Obama and the Dems have a lot to do on health care, not just in getting states to sign on, but also in convincing the public that the Affordable Care Act is the best option in ensuring and bettering our health.

 

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 (Photo: Kevork Djansezian/Getty Images)

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