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Pressure Growing On Christie To Approve Medicaid Expansion

phillyBurbs.com — Wednesday, February 6, 2013

By David Levinsky
Staff writer

Gov. Chris Christie may not be a fan of the Obama administration's health care reform law, but pressure is building on the Republican governor to embrace one of its major components: an expansion of Medicaid to give more poor adults access to government care.

Ohio's John Kasich, who like Christie was critical of the federal Affordable Care Act, became the latest Republican governor to support the Medicaid expansion component Monday, when he introduced a budget that embraced the federal-state partnership. The others are Arizona Gov. Jan Brewer and Nevada Gov. Brian Sandoval.

New Jersey advocates said Kasich's decision will put more pressure on Christie to follow suit and have New Jersey join the 17 states that so far have opted to expand their Medicaid rolls.

"When you see more Republican governors make this choice, I think it becomes more clear that it's both the logical thing to do and the right thing to do," said Yarrow Willman-Cole, an organizer with the advocacy group New Jersey Citizen Action, which is campaigning for the expansion. "We hope Gov. Christie will likewise make the right choice."

Christie has been largely mum on the issue, saying recently that he wouldn't discuss it until he reaches a decision. He said last summer that he wasn't sure New Jersey should expand Medicaid under the federal law because the state's program already covers many poor and disabled residents.

Ray Castro, a senior analyst with the liberal-leaning New Jersey Policy Perspective, said a lot has changed since then, including President Barack Obama's re-election and growing support for the expansion.

"There was a whole lot of political rhetoric going on during the summer, but now, especially with the Republican governors' support, it's become much less of a partisan issue," Castro said Tuesday, adding that the reasons cited by Kasich to support Ohio's expansion also apply to New Jersey.

"There's federal funding at stake that can affect job creation and the state's competitiveness and finances," he said.

Medicaid is a state-run insurance program for the disabled, elderly and poor that the federal government helps fund. Currently, most of New Jersey's Medicaid health care recipients are children and their low-income parents. Under a provision of the Affordable Care Act, eligibility for the program would be raised next year to 138 percent of the poverty level, or $15,414 a year for a single adult and $26,344 for a family of three.

The change would make an estimated 233,000 uninsured adults living in the state eligible to enroll in Medicaid, with the federal government absorbing all costs for the new enrollees for the first three years and at least 90 percent of the costs in the ensuing years.

The federal government now picks up the tab for about half of the costs of New Jersey's Medicaid enrollees.

Critics of the proposed expansion have expressed doubts that the federal government will be able to keep its funding promise, and that New Jersey taxpayers could eventually get stuck with a greater share of the multibillion-dollar bill.

"It seems like every day there's a new report on the high cost of Obamacare. I find it shocking anyone would want to add to this mess," said Steve Lonegan, state director of the New Jersey branch of the conservative group Americans for Prosperity, which is actively campaigning against the state's expansion.

Castro said the federal government is now saying that states can automatically opt out of the expansion if the reimbursement levels change, a clause cited by Kasich.

"It's an easy out, and it really closes the only reasonable argument you could make against expansion," he said.

Of course, there are still political ramifications to any decision, particularly for Christie, who is up for re-election this year as well as a leading contender to become the GOP's presidential nominee in 2016.

State Sen. Barbara Buono, the Democratic candidate most likely to face Christie this fall, issued a statement Monday night challenging the governor to stop "waffling" on the issue of Medicaid expansion.

"Yet another Republican governor accepted federal funding to expand Medicaid coverage for his most vulnerable constituents," Buono said in a statement. "Ohio Gov. John Kasich's announcement stands in stark contrast to Gov. Christie's waffling on the issue. By delaying his decision, Gov. Christie is not only leaving 300,000 New Jerseyans without health insurance, he is increasing health care costs as the uninsured are forced to use the emergency room as a primary care provider."

Lonegan said Kasich's decision was disappointing, but he expressed confidence that Christie would not be swayed.

"It's a huge disappointment, but it's Ohio, not New Jersey," he said. "I don't think it will spread to New Jersey."

A recent poll commissioned by the American Cancer Society's action network found public sentiment in New Jersey largely favored the expansion.

The poll, which was based on a mid-December telephone survey of 812 registered voters, found 70 percent supported the state's accepting federal funding for Medicaid expansion, compared with 21 percent who opposed and 9 percent who were unsure.

Among various demographic groups, only Republicans were opposed, with 40 percent for accepting federal funds for Medicaid expansion and 47 percent against; 12 percent were still unsure. By comparison, 92 percent of Democrats and 68 percent of independents were in favor of New Jersey accepting the funding.

The poll has a margin of error of plus or minus 3.5 percent.

Willman-Cole said New Jersey residents understand that Medicaid provides a crucial safety net and that expanding the program makes sense.

"The support is building, especially viewed outside the political context. This is important for New Jersey and can't be politically motivated," she said.

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