President Obama wants to sweeten the deal for 19 states that have refused to expand their Medicaid programs under Obamacare, saying Congress should reset the clock on generous federal matching funds that were set to wind down after this year.
Louisiana Gov. John Bel Edwards, a Democrat, moved to expand Medicaid on the first day of his tenure this week, meaning 31 states, plus D.C., have decided to extend government-sponsored insurance to those making up to 138 percent of the federal poverty level.
A key pillar of the Affordable Care Act, the expansion was supposed to fill gaps in health coverage for low-income Americans. People who make more than the federal poverty level can qualify for subsidies that make it easier to afford private plans from web-based health exchanges.
But the Supreme Court in 2012 said states could refuse to expand the federal-state health program without forfeiting existing federal funds.
While some Republican leaders seized the chance to cover tens of thousands of residents with new federal funding, others held out, saying expansion would bust their state budgets when the federal government stopped picking up the full tab for newly eligible residents.
Mr. Obama wants to allay those concerns by letting states enjoy a full three years of 100 percent matching funds out of Washington.