It's the hottest trend sweeping the nation: Refusing free money from the federal government to insure millions of poor people by expanding Medicaid. Today, the annual National Governors Association meeting kicks off in Williamsburg, Virginia and the topic du jour is the federal government's expansion of Medicaid under Obamacare. Some states welcome the federal funds, which aim to make 22 million uninsured Americans eligible for Medicaid beginning in 2014. Others want no part of it, fearing the program will explode state budgets. (Although the feds initially pay for 100 percent of the Medicaid expansion, that figure goes down to 90 percent by 2020.) Either way, today's conference puts Democratic and Republican governors who are on the fence about participating in the program in the political hot seat. The last few weeks have left news outlets scrambling to find out, who's in, who's out and who's wavering on the issue. Here's where the country stands based on data and recent interviews gleaned from Reuters, USA Today, The Washington Post and The New York Times.
In total 27 states have not decided whether to opt-in yet but, as The Washington Post's Felicia Sonmez notes, with a series of Republican governors already vowing to opt-out, this puts certain high-profile Republican governors in a tight spot. Chief among those: Virginia Gov. Bob McDonnell, New Jersey Gov. Chris Christie and Georgia Gov. Nathan Deal, all of whom have not announced a position. On the Democratic side, N.C. Aizenman and Karen Tumulty note that "At least seven Democratic governors have been noncommittal about their willingness to go along with expanding their states’ Medicaid programs." The entire list includes: Alabama, Alaska, Arizona, Colorado, Georgia, Idaho, Indiana, Ohio, Oklahoma, Kansas, Kentucky, Maine, Michigan, Missouri, Montana, Delaware, New Hampshire, New Mexico, North Carolina, North Dakota, Pennsylvania, South Dakota, Tennessee, Utah, Virginia, West Virginia, Wisconsin and Wyoming.
These Republican-dominated states have vowed to opt-out, which has typically corresponded with a statement from the governor.
Florida. Governor Rick Scott said the program would not help economic growth in the state "and since Florida is legally allowed to opt out, that's the right decision for our citizens."
Texas. Gov. Rick Perry said Obamacare and Medicaid "both represent brazen intrusions into the sovereignty of our state."
Mississippi. Governor Phil Bryant: "Simply put, Mississippi cannot afford a Medicaid expansion."
South Carolina. Gov. Nikki Haley: "We simply can't support this."
Iowa. Gov. Terry Branstad: "It would be irresponsible to put Iowans on the hook for a potential $1 billion tax increase should they fail to provide funding,"
Louisiana. Gov. Bobby Jindal: "Do we set up these exchanges, and secondly, do we expand Medicaid? ... No, in Louisiana we're not doing either one of those things."
The Coalition of the Willing
These states, and the District of Columbia, either have expanded already or plan to do so. Though each governor has not necessarily issued statements directly (typically a state's Health and Human Services Agency deal with compliance).
California. The state is making its way to complying with both insurance exchanges and Medicaid expansion.
Connecticut. Gov. Dan Malloy, a Democrat, has said his state plans to fully implement the plan.
District of Columbia. Wayne Turnage, director of the Department of Health Care Finance: “We will continue to move forward with implementation of this landmark legislation for District residents."
Hawaii. Gov. Neil Abercrombie: “We are planning to fully implement our state-based exchange and the Medicaid expansion."
Illinois. Deputy Gov. Cristal Thomas: “We’ll move forward to deliver the benefits of the Affordable Care Act to millions of people in Illinois."
Maryland. Gov. Martin O'Malley supports and plans on expanding Medicaid.
Massachusetts. Gov. Deval Patrick plans to fully adopt the expansion.
Minnesota. The state plans on expanding it's Medicaid plan.
New York. Gov. Andrew Cuomo has ordered its state's bureaucracy to begin compliance.
Vermont. Gov. Peter Shumlin supports the Medicaid expansion.
Washington. Karina Shagren, a spokeswoman for Gov. Chris Gregoire: ”Our state has already moved to develop a health care exchange. Our governor also supports the Medicaid expansion."