The Affordable Care Act and Medicaid: The Path to Universal Expansion

Session Submission Type: Roundtable

Session Description

Medicaid is nearly sixty years old. It began as a federal/state program to provide medical payments for the welfare recipients. In the ensuing decades eligibility was expanded to include many of the poor and disabled individuals not receiving cash welfare, pregnant women and many older Americans needing home care. However, its link to the welfare system was never completely broken. With the 2010 enactment of the Affordable Care Act Medicaid expansion was envisioned to finally include all poor citizens irrespective of their link to state welfare systems. The 2012 Supreme Court decision rendered Medicaid expansion optional for the states. Many states immediately accepted Medicaid expansion, but others did not. Over the past decade the Medicaid expansion has now been adopted by all but ten states, but the holdouts include large states, such as Texas, Florida and Georgia, with their large uninsured populations.

John Kingdon’s Three Streams Model provides a useful framework for the examination of the policy process. In this conceptual framework the Policy Stream consists of communities in which policy ideas are debated, evaluated, and reconstituted. The focus of the proposed Roundtable is examination of the policy options to permanently achieve universal Medicaid expansion.

In the past few years there have been extensive assessments of the impact on health of expanded Medicaid coverage. but less emphasis on the policy options available to achieve full adoption of Medicaid expansion. Among the options to be discussed are grassroots use of the initiative process (such as recently in Missouri and Oklahoma) and continued state legislative efforts (as recently in North Carolina). The Build Back Better early version included new financial incentives for states to adopt Medicaid expansion, and partial or complete federalization of Medicaid has been discussed periodically over the decades.

The Roundtable will draw on a wide range of scholarly perspectives to discuss and evaluate a variety of the policy ideas to accomplish complete Medicaid expansion based on technical, political, and administrative feasibility.

Proposed Participants:

William Brandon
Professor Emeritus
University of North Carolina, Charlotte
wilbrand@charlotte.edu

James Brasfield- Chair/Facilitator
Professor Emeritus
Webster University
Jimbrasfield@mac.com

Colleen Grogan
Professor
University of Chicago
cgrogan@uchicago.edu

Jake Haselwerdt
Associate Professor
University of Missouri
haselswerdtj@missouri.edu

Jamila Michener
Associate Professor
Cornell University
jm2362@cornell.edu

Harold Pollack
Professor
University of Chicago
haroldp@uchicago.edu

Philip Rocco
Associate Professor
Marquette University
philip.rocco@marquette.edu

Michael Sparer
Professor
Columbia University
mss16@cumc.columbia.edu

Sub Unit

• Division 48: Health Politics & Health Policy

Chair

• James M. Brasfield Webster University

Presenters

• William P. Brandon University of North Carolina, Charlotte

• Colleen M. Grogan University of Chicago

• Harold Pollack University of Chicago

• Philip B. Rocco Marquette University

• Michael S Sparer Columbia University

• Jake Haselswerdt University of Missouri, Columbia