Looking to the future
Dillon, Saloner, and officials at the Arkansas Hospital Association say the odds are good for Medicaid expansion to take hold nationwide.
"Missouri will eventually move forward," Dillon says. "We hope it will be this year. Other states have provided a laboratory for state-specific reform efforts. … We believe that the momentum is gathering."
In an email last week, Arkansas Hospital Association officials said they are bullish on the prospects of nationwide Medicaid expansion because the federal agency in charge of the effort has shown a willingness to finesse the issue. "[The Centers for Medicare & Medicaid Services] has shown it is open to ideas that allow coverage of those eligible, and states are now exploring those alternatives. This will lead to more states expanding their coverage over time."
After states have expanded their Medicaid programs to serve adults under the age of 65, it will be hard to turn back the clock, Saloner said.
"Once a program is in a state, it's really hard to unravel," he said. "Once benefits are expanded, it's difficult to go back to a place where you don't have that level of coverage and level of federal financing."