Medicaid Expansion Leadership Team (MELT)

States are poised to expand health care coverage to hundreds of thousands uninsured in the wake of the support for Medicaid programs in states following recent elections. The Medicaid Expansion Leadership Team (MELT) will take advantage of Families USA’s leadership role in organizing and securing the recent Medicaid expansions in Utah, Idaho, and Nebraska through passage of ballot initiatives and our in-depth work in other states on Medicaid waiver and related issues to embrace this opportunity.

Families USA’s Medicaid Expansion Leadership Team combines the policy expertise of veterans of the Centers for Medicare and Medicaid Services with the political savvy of our state advocacy network to support expansion efforts. The outcomes of the 2018 elections created a unique, time-sensitive opportunity to provide health coverage to more than half a million people living in key states through Medicaid expansion. Successful expansion in Utah, Idaho, Nebraska, North Carolina, Kansas and Wisconsin will not only reduce the number of uninsured adults and families living in these states, it will also strengthen a national support for health care coverage and highlight the benefits of Medicaid.

The political environment in these states necessitates that expansion efforts must be undertaken in a pragmatic and bipartisan manner that involves both state-based consumer groups as well as key governors and legislative leadership.

In order to highlight the benefits, state budget savings and economic impact of Medicaid Expansion, the MELT is creating resources and guides to assist policymakers in understanding the value of the increased health care coverage for the uninsured. Families USA has produced an initial resource, the Medicaid Expansion Toolkit, for state health care leaders to use as and understand the process involved in the implementation of Medicaid expansion in states. The toolkit includes the following fact sheets:

• State Plan Amendment Approval Time Frames. This analysis summarizes the SPA approval process and identifies where delays in the process might occur.
• State Plan Amendment vs Medicaid 1115 Waiver Process and Timelines. This fact sheet provides advocates and policymakers a step-by-step overview comparing the approval process and timeline to get a SPA vs. Medicaid 1115 Waiver approved.
• Options to Generate the State Share of Medicaid Expansion Costs. This fact sheet provides an analysis of the various strategies states utilize to generate the state share – the 10 percent – of the cost of expanding Medicaid.
• The Impact of Medicaid Expansion on State Budgets. This analysis synthesizes the areas where Medicaid expansion at the enhanced federal match has generated state savings across multiple budget areas, offsetting most or all of the state’s share of expansion costs.
• Partial Expansion Does Not Really Close the Coverage Gap: The Impact of Individual Market vs. Medicaid Expansion Coverage for 100-138% FPL Population. This analysis highlights the coverage and financial burden that non-elderly adults between 100-138% of the Federal Poverty Level experience when enrolled in individual market coverage compared to coverage under Medicaid expansion. We show that Marketplace coverage is simply not adequate or appropriate for near poor individuals and families.