Red States Are Reinventing Medicaid to Make It More Expensive and Bureaucratic
Since the implementation of the Affordable Care Act’s Medicaid expansion in 2014, 23 states have refused the federal money to offer health insurance to their low-income residents, depriving almost 4 million people of coverage. Slowly, some of the holdout red states are finding a way to say yes, but only if they can claim a conservative twist on expanding coverage. Tennessee last week became the latest state to release details on a proposal for its own unique version of Medicaid expansion via a waiver of Medicaid rules (known as an 1115 waiver). "We made the decision in Tennessee nearly two years ago not to expand traditional Medicaid," Gov. Bill Haslam, a Republican, has said. "This is an alternative approach that forges a different path and is a unique Tennessee solution.”