Most States Expected to Expand Medicare

Several Republican governors originally rebelled against Obamacare by refusing to expand eligibility to their state’s Medicaid program. But more and more are caving in. An analysis by Decision Resources Group finds that most states will move toward Medicaid expansion in the next few years. Hospital systems in non-expansion states are losing millions of dollars on uncompensated care, not to mention the millions of federal dollars left on the table with waiver-based initiatives.

Ric Gross, senior analyst at Decision Resources Group said, “One noteworthy byproduct of the state-by-state Medicaid expansion battle is the level of experimentation allowed by the Obama administration. Republican-heavy states, such as Arkansas and Iowa, received CMS permission to move Medicaid expansion beneficiaries into the private exchange. This level of adaptation has prompted other states, such as Indiana, to push for even more liberties in a bid to expand. While CMS won’t simply rubber stamp these requests, they certainly want as many states as possible to open up the program and bring more uninsured into the fold.”

While states generally aren’t shrinking their use of managed care organizations, several are expanding managed Medicaid in varying capacities as they seek to restrain healthcare cost increases. More states are implementing accountable care organizations in their Medicaid programs to coordinate care for the sickest beneficiaries. However, after an early flurry of interest from 26 states in 2012, just 12 are moving ahead with demonstration projects to coordinate care for those who qualify for full Medicaid and Medicare benefits. For more information, visit In related news, the White House issued a report on the economic consequences for states that don’t expand Medicaid.  For more information download

Last Updated 08/10/2022

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