States' Medicaid programs will have to grow dramatically to meet
the demands of healthcare reform. Those states that have already
started the process could come out ahead financially.
Under the nation's healthcare reform plan, the nation's Medicaid
system will grow as one of the main organizations to implement the
goal of expanded medical coverage.
But it appears that, from a financial standpoint, some states
will be winners and some will be losers in this new arrangement.
Here's a look at why some states may stand to benefit. Later
today, the Monitor will look at other states, which are complaining
that it will cost their taxpayers a lot more money in the future.
The biggest winners, state officials and Medicaid experts say,
could be those states that have already taken an important step
toward expanding their own Medicaid programs: covering childless
The reason for the coming windfall: These states are already
paying for something that the new healthcare plan will soon mandate,
and as the law's provisions begin to kick in, the federal government
will actually pick up much of the burden that these states are now
The winners: 11 states plus D.C.
The 11 so-called "expansion states" states are: Arizona,
Delaware, Hawaii, Maine, Massachusetts, Minnesota, New York,
Pennsylvania, Vermont, Washington, and Wisconsin, plus the District
Currently, states that cover childless adults receive a 50
percent reimbursement for their costs. But the federal share of that
reimbursement is set to increase, according to the bill of
healthcare fixes, which tweak some of the numbers in the healthcare
bill already passed and signed by President Obama.
(The fixes bill was passed by the Senate and the House Thursday
and now goes to Mr. Obama to be signed into law.)
In 2014, the federal government will pick up 75 percent of the
costs. By 2020, the fed's share will grow to 93 percent.
By contrast, states that have not yet begun to cover childless
adults will get federal reimbursements to cover 100 percent of their
programs to start, but over time they will have to start paying for
a portion of the cost. In other words, their expenses will
eventually grow, while those of states that got a head start will
Although it's hard to quantify how much these states will save as
a result of the changes, it will total in the billions of dollars
Sitting pretty: New York, Maine
For example, since the year 2000, New York state has been
providing Medicaid healthcare benefits for childless adults and
parents at the federal poverty level ($10,800 for a single adult;
$14,570 for two adults). As of February there were 388,000 people in
Under the healthcare fixes - officially known as the
reconciliation bill - the state would see a net gain of $2.1
billion, estimates Rep. …