Some states still dubious of ACA

January 12th, 2015

A week after the Supreme Court’s affirmation of the Affordable Care Act, reaction continues to be mixed. Meanwhile, insurance companies are looking over their plans to see what needs to be implemented, while states will begin laying groundwork for healthcare exchanges and consider impending Medicaid expansion.

Well… some states are. However, the governors of Georgia and Louisiana are refusing to implement the changes, instead pinning their hopes on a possible repeal of the law through legislation.

"Obviously, the elections in November will determine a lot of these decisions that will have to be made by the state at some point in time," said Georgia Gov. Nathan Deal. "We are probably just going to be in a holding pattern until such time as we see what the events of November bring us." Deal said the state will hold off on deciding whether to go through with the Medicaid expansion and how to proceed on forming the state insurance exchange until after the November elections.

Louisiana Gov. Bobby Jindal was more forceful. "Here in Louisiana we have not applied for the grants, we have not accepted many of these dollars, we're not implementing the exchanges," Jindal said. "We don't think it makes any sense to implement Obamacare in Louisiana. We're going to do what we can to fight it."

While the states may be taking a gamble by putting off the creation of state insurance exchanges, there is now more wiggle room with Medicaid expansion.

The high court ruled that Medicaid funds cannot be taken away if a state does not implement a sweeping Medicaid expansion set forth by the ACA. Under the expansion – to be implemented by 2014 – those who earn less than 133% of the poverty level will be eligible to receive Medicaid, which would increase the rolls by millions. States faced having all federal Medicaid funds rescinded if they did not comply, but the court’s ruling will eliminate that penalty. The states will only risk losing new funding if they choose to remain under the current program.