Medicaid expansion battle rages in 5 remaining states

After the New Hampshire House of Representatives voted this week to send its Medicaid expansion bill to Democratic governor Maggie Hassan, only five states remain undecided on implementing Obamacare’s controversial Medicaid expansion program.

Since the Supreme Court ruled in 2012 that Obamacare’s mandate expanding Medicaid eligibility to all adults below 138 percent of the federal poverty level must be ratified individually by each state, a fierce pressure campaign has been waged on the state level by left-wing groups like MoveOn.org and hospital interests who stand to gain from the expansion. The Obama administration has been ramping up the pressure, with Health and Human Services Secretary Kathleen Sebelius recently accusing Republican governors of “playing politics with people’s lives.”

Though 19 states, including Rick Perry’s Texas and Bobby Jindal’s Louisiana, have opted to ignore the expansion, a number of Republican governors have caved in. New Jersey’s Chris Christie, head of the powerful Republican Governors Association, Arizona’s Jan Brewer, New Mexico’s Susana Martinez, and Ohio’s John Kasich, who served as House Budget chairman during Newt Gingrich’s speakership and has a Republican-controlled legislature, all approved the Obamacare expansion.

Five states remain in limbo. Their situations include a moderate Republican governor battling his own party, a vulnerable Republican governor up for re-election making major compromises, a liberal Democrat fighting House Republicans to a government shutdown, a conservative governor trying to take federal money without calling it Medicaid expansion, and one state where strong Republicans genuinely have the plan dying in a ditch. Here are the five battlegrounds:

Pennsylvania: Republican governor up for re-election caving fast and caving hard

Corbett has pitched a state-run program that would use federal money to purchase private plans for eligible Pennsylvanians, similar to the plans approved in Arkansas and Iowa. After months of Democratic attacks on his plan’s work-search requirement, Corbett updated his “Healthy Pennsylvania” plan last month, keeping in place the basics but erasing some of the coverage limits included in his first draft. His biggest concession came in a March 5 letter he wrote to Kathleen Sebelius, in which he re-designed his work-search requirement as a one-year pilot program that would give benefits to Medicaid recipients who choose to search for work. “This pilot program will not be a condition of eligibility, but rather those individuals who participate will lower their premiums and cost-sharing as incentives,” Corbett wrote.

Pennsylvania’s Democratic state treasurer Rob McCord, who supports full Medicaid expansion and is running against Corbett in this year’s gubernatorial election, said Monday that he will unilaterally throw out Corbett’s plan if approved in full by the Obama administration and will wait to see which parts of the plan are approved before deciding which ones he will undo. Considering the politics surrounding the 2014 gubernatorial race, in which Corbett is viewed as a relatively weak incumbent facing Republican primary opponents, Corbett’s fight against full Medicaid expansion is looking weaker and weaker by the day.