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Capitol Correspondence - 02.11.19

Senate Democrats Weigh Added Incentives for Medicaid Expansion Hold-Out States – Potential Interest for DSP Workforce

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ANCOR is sharing the article below by Politico Pro because Medicaid expansion could be a very impactful policy for the Direct Support Professional (DSP) occupation, which is focused on helping people with disabilities live life like everyone else. While data specific to DSPs is not hugely available, DSPs are generally considered under the umbrella of personal care aides / home health care aides. According to the Paraprofessional Health Institute (PHI), nearly one in five home care aides live below the federal poverty line, and more than half of home care aides receive some form of public assistance – including Medicaid. As such, Medicaid expansion is likely to cover the DSP workforce. This bill will have to be reviewed by the Senate Finance Committee, which is now being chaired by Senator Chuck Grassley (R-IL). Members interested in learning more about Senator Grassley’s role might be interested in this new column by George Will.

“Democrats see an opportunity to expand incentives to push the remaining 15 ‘holdout’ states to expand Medicaid under the Affordable Care Act, after three red states voted overwhelming for expansion in 2018.

Sen. Doug Jones [D-AL] announced this morning that he will soon introduce a bill with Sen. Mark Warner [D-VA] to give ‘holdout’ states more financial incentives to expand Medicaid under the Affordable Care Act, allowing them to get the same full federal match that states got in the first three years of the ACA.

In a speech at National Rural Health Association’s annual policy conference, where he accepted an award, Jones said he is ‘sick and tired’ of GOP-controlled states like Alabama opposing Medicaid expansion ‘for political reasons’ when the data on improved health outcomes is so overwhelming.

His fellow Alabamian, Rep. Terri Sewell [D-AL], is pushing the same bill in the House along with Rep. Marc Veasey, (D-Texas). Both conservative states have struggled with high uninsurance rates as political leaders have refused the ACA’s Medicaid expansion. Rural hospitals in nonexpansion states also face greater cost pressures, and more have closed.

Jones, who is up for reelection in 2020 and is considered one of the Senate’s most vulnerable Democrats, made Medicaid and the Children’s Health Insurance Program a key part of his platform in his upset 2017 special election race and in his time in office.”

Members wanting to learn more about the general landscape for Medicaid expansion might be interested in an upcoming webinar by Health Management Associates (HMA), which “will provide an overview of the Medicaid expansion market and take a close look at which of the remaining states are most likely to pursue expansion and why. HMA will also address some of the important program variations states are most likely to consider when shaping expansion benefits.”