Where each state stands on ACA's Medicaid expansion A roundup of what each state's leadership has said about their Medicaid plans

IMPORTANT NOTE FOR READERS

July 26, 2013



We are no longer updating this version of the Medicaid map, which tracked each governor's stance on the Medicaid expansion.



Check out our new Medicaid Map July 26, 2013We are no longer updating this version of the Medicaid map, which tracked each governor's stance on the Medicaid expansion.Check out our new Medicaid Map (Beyond the pledges: Where the states stand on Medicaid ), which tracks executive and legislative action taken to achieve—or totally rule out—expansion in each state.

The Supreme Court's ruling on the Affordable Care Act (ACA) allowed states to opt out of the law's Medicaid expansion, leaving each state's decision to participate in the hands of the nation's governors and state leaders.

Based on lawmakers' statements, press releases, and media coverage, the Daily Briefing and American Health Line editorial teams have rounded up where each state currently stands on the expansion.

We will continue to update this map and list as more information becomes available. Send us news, tips, and feedback by commenting below or emailing dailybriefing@advisory.com.

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A state-by-state look at governors' stances

Text last updated on June 14, 2013. States are categorized based on statements from governors or enacted state laws.

* indicates a state's participation in the multistate lawsuit against ACA

NOT PARTICIPATING (13 states)

LEANING TOWARD NOT PARTICIPATING (6 states)

Alaska*: Gov. Sean Parnell (R) on Feb. 28 expressed opposition to the Medicaid expansion. He said he will not ask the state Legislature to consider expansion this session, but he will continue to examine the issue (Bohrer, AP/Alaska Journal of Commerce , 3/1/13).

Gov. Sean Parnell (R) on Feb. 28 expressed opposition to the Medicaid expansion. He said he will not ask the state Legislature to consider expansion this session, but he will continue to examine the issue (Bohrer, , 3/1/13). Kansas*: Gov. Sam Brownback (R) has punted the decision on Medicaid expansion to Kansas' Republican-controlled legislature. Lawmakers have not reached consensus on the issue, and a state budget amendment that is expected to pass would prohibit Brownback from expanding the program without the support of the legislature (Celock, Huffington Post , 5/6/13).

Gov. Sam Brownback (R) has punted the decision on Medicaid expansion to Kansas' Republican-controlled legislature. Lawmakers have not reached consensus on the issue, and a state budget amendment that is expected to pass would prohibit Brownback from expanding the program without the support of the legislature (Celock, , 5/6/13). Nebraska* : Gov. Dave Heineman (R) in a statement on his website on June 28 said, "As I have said repeatedly, if this unfunded Medicaid expansion is implemented, state aid to education and funding for the University of Nebraska will be cut or taxes will be increased. If some state senators want to increase taxes or cut education funding, I will oppose them." Heineman on July 11 sent a letter to state lawmakers saying the state could not afford the expansion, but he stopped short of saying that the state will not participate in the expansion, according to Reuters (Office of Gov. Heineman release, 6/28/12; Wisniewski, Reuters , 7/11/12).

: Gov. Dave Heineman (R) in a statement on his website on June 28 said, "As I have said repeatedly, if this unfunded Medicaid expansion is implemented, state aid to education and funding for the University of Nebraska will be cut or taxes will be increased. If some state senators want to increase taxes or cut education funding, I will oppose them." Heineman on July 11 sent a letter to state lawmakers saying the state could not afford the expansion, but he stopped short of saying that the state will not participate in the expansion, according to (Office of Gov. Heineman release, 6/28/12; Wisniewski, , 7/11/12). Utah* : Gov. Gary Herbert (R) has not yet announced a decision on Medicaid expansion. He has asked the state health department to convene a workgroup to examine cost-effective alternatives that would expand coverage for low-income residents (Dobner, Salt Lake Tribune , 4/23/13).

: Gov. Gary Herbert (R) has not yet announced a decision on Medicaid expansion. He has asked the state health department to convene a workgroup to examine cost-effective alternatives that would expand coverage for low-income residents (Dobner, , 4/23/13). Virginia* : Although Gov. Bob McDonnell (R) has not made an official announced on the Medicaid expansion, he has expressed opposition to the ACA provision, according to the Virginian-Pilot . However, the Pilot notes, the future of the state's Medicaid expansion will likely depend on the outcome of the November gubernatorial election: Democrat Terry McAuliffe support expansion, but Republican Ken Cuccinelli opposes it (Walker, Virginian-Pilot , 4/11/13).

: Although Gov. Bob McDonnell (R) has not made an official announced on the Medicaid expansion, he has expressed opposition to the ACA provision, according to the . However, the notes, the future of the state's Medicaid expansion will likely depend on the outcome of the November gubernatorial election: Democrat Terry McAuliffe support expansion, but Republican Ken Cuccinelli opposes it (Walker, , 4/11/13). Wyoming*: Gov. Matt Mead (R) on Nov. 30 recommended that Wyoming not participate in the Medicaid expansion, but added that his position could change in the future and urged "everyone to keep an open mind on this." The state legislature will make the final decision on whether to expand the program, the AP/Jackson Hole Daily reports (Brown, Wyoming Tribune Eagle, 12/1/12; Graham, AP/Jackson Hole Daily, 12/1/12).

LEANING TOWARD PARTICIPATING (1 states)

New York: Gov. Andrew Cuomo (D) in a statement on his website on June 28 said he was "pleased the Supreme Court upheld the [ACA]" and looks forward "to continuing to work together with the Obama administration to ensure accessible, quality care for all New Yorkers." On July 26, Danielle Holahan—project director for New York's health insurance exchange planning—said the state "largely meet[s] the federal required Medicaid levels already." Although Cuomo's office has not officially announced a decision, the Associated Press reported on Nov. 13 that New York will expand Medicaid (Office Gov. Cuomo release, 6/28/12; Grant, North Country Public Radio, 7/27/12).

PARTICIPATING (26 states and the District of Columbia)

Participating through an alternative expansion model (4 states)