To Expand Or Not To Expand Medicaid: A Nationwide Draw?

Who likes a tie (or a draw) in sports? Not me!

In the last few years, I have noticed that, increasingly, parents of young children in sports are not keeping score.  You can go to a ten-year-old’s soccer game and ask the score, only to hear, “Oh, we don’t keep score.  We believe that everyone is a winner.”

Without stepping up onto my soapbox, let me just say I think “scoreless games” are as worthless as the nonexistent scores themselves.  I mean, come on, our country was founded on doing your best, working hard and receiving just compensation for hard work. (Not to mention that I grew up participating in competitive sports (gymnastics), and I truly believe that my participation in a competitive sport has contributed to my work ethic today).

Even Ashton Kutcher, during a recent Teen Choice Awards speech, surprised many with a speech about hard work and that opportunity looks a lot like hard work.

But, it is a different story when the teams actually keep score and the end result is still a draw.  When you keep score and the result is a draw, generally, that means that two teams with similar ability played and both played hard and both kept one another at bay.

Like the 1996 hockey game between Colorado Avalanche and Buffalo Sabres…both teams bragged it had the best goalie.  They played (and kept score) and recorded a shutout (0-0) tie game.  Apparently, both goalies were equally great.

Going to Medicaid expansion. That’s an old topic for North Carolina, right? But not for the U.S…

Yes, Governor McCrory nixed NC Medicaid expansion in NC.  Which, BTW, in my humble opinion, was a smart choice.  But, before everyone starts screaming cuss words at the computer screen, read my blog: Medicaid Expansion: Bad for the Poor.

But, remember, other states are still wrestling with the idea of Medicaid expansion.

Decisions are being made every day.  Just yesterday, Wyoming lawmakers announced that they were considering an alternative to Medicaid expansion. (As in, it would pretty much be Medicaid expansion, but named something else to avoid the appearance of concurring with the Affordable Care Act (ACA)).

So what is each state’s stance on Medicaid expansion?

Go figure….close to a tie.

Here is each state’s stance on Medicaid expansion as of July 26, 2013:


So the score is 28-22 (counting those states “leaning” as decided).  Not exactly a tie, but pretty close.

The tie is especially interesting when you consider that the “score” of Republican to Democrat governors in the U.S. is 30-20.


The red states denote Republican governors; the blue states elected Democratic governors.

Although, remember, 18 states still have not decided whether to expand.  Which means, the score could be 46-4 or 10-40.  Whew….neither of those scores is a tie!

So what does this “close to a tie” in Medicaid expansion mean? Especially with the majority of governors nationwide affiliated as Republicans…Anything?

Maybe not.

But maybe.

But, at least, we are keeping score.  At least both teams are playing to the best of its ability.  In the end, there will be a winner.

As there should be.

Hopefully, in the end, the winners will be the Medicaid recipients. (One can hope).

About kemanuel

Medicare and Medicaid Regulatory Compliance Litigator

Posted on August 27, 2013, in Affordable Care Act, Division of Medical Assistance, Federal Law, Health Care Providers and Services, Legislation, Medicaid, Medicaid Expansion, Medicaid Recipients, Medicaid Reform, Medicaid Services, NC DHHS, North Carolina, Obamacare, Tax Dollars and tagged , , , , , , , , , , , , , , , . Bookmark the permalink. 3 Comments.

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