The ‘Medicaid Expansion’ Map: Where We Stand

By Gregg A. Masters, MPH

Courtesy of the good peeps at The Advisory Board, aka @TheAdvisoryBd, the emerging picture of where we are going in terms of the mission critical leg of full ACA implementation, rests to a large degree with the Executive Offices of the respective states. As can be expected, there is a reasonable correlation between ‘Red state v. Blue state’ governance with respect to the tapestry of intended implementation.

ACO and derivative implementation efforts (i.e., outside of the Federal regulation of the Medicare Shared Savings program et sequelae) both on and off the ‘balance sheet’ if you will, are directly related to the full implementation of the Act. Whether ACOs can manifest and achieve the intention of the Triple Aim is likely to be substantially muted if Medicaid expansion remains ‘optional’.

Two noted outspoken critics of the Act are former disgraced CEO of Columbia/HCA, founder of Conservatives for Patient’s Rights, and current Governor of the state of Florida, Rick Scott, as well as the outspoken and somewhat controversial ‘Mr. oops’ and reported notorious secessionist threat, Texas Governor Rick Perry.