President Obama, who has struggled for more than five years to overcome opposition to his signature healthcare law, hasn't had much to cheer in the Deep South.
But he came to this southern capital on Thursday to celebrate Louisiana's new Democratic governor, who within a day of taking office this week announced he would expand the state’s Medicaid program through the Affordable Care Act.
The move could offer health coverage to about 300,000 people in the state that struggles with widespread poverty.
“It shows you why elections matter,” Obama about told a crowd of about 1,000 people at McKinley High School.
Gov. John Bel Edwards, who made expanding Medicaid rolls a key promise of his campaign last year, is “already delivering for the people of Louisiana,” Obama said.
Edwards signed an executive order Tuesday, his first full day in office, that will allow low-income adults in the state to begin signing up for Medicaid starting July 1. Lousiana became the 31st state, and the first in the Deep South, to undertake the expansion.
As part of a trip meant to reinforce his State of the Union message, Obama highlighted the expansion here as a validation of the healthcare law, commonly called Obamacare, that he considers a signature achievement of his tenure.
During a question-and-answer session on Twitter after the town hall event here, Obama said the night the Affordable Care Act passed in 2010 was the best moment of his presidency.
He recalled standing on the White House’s Truman Balcony with his team “knowing we'd helped millions.”
On Thursday his administration proposed new federal aid to persuade more states to expand their Medicaid programs through the healthcare law.
Medicaid, along with new insurance marketplaces created by the health law, has helped expand coverage to 17 million Americans since 2013, driving the largest reduction in the number of people uninsured in half a century.
Medicaid now provides coverage to nearly 1 in 4 Americans at a total annual cost to taxpayers of more than $500 billion.
The program is growing rapidly, thanks largely to the law, which provides hundreds of billions of dollars in federal aid to states to expand Medicaid eligibility to low-income, working-age adults. The program historically had served poor children, mothers and the disabled.
Many Republican governors and state lawmakers have rejected the expansion despite growing evidence about the benefit to patients. The opponents argue that Medicaid is ineffective and too costly.
Though the law provided federal funding to fully pay for the expansion in 2014, 2015 and 2016, the aid is gradually phased down so states will ultimately pay 10% of the cost in 2020, a prospect many local lawmakers find worrisome, given doubts about the price tag.
That means that if a state such as Florida, which has opposed the law, decides in 2017 to expand Medicaid, it would not be eligible for full federal support.
Obama’s new proposal would change that. It would allow any state that decides to expand Medicaid eligibility under the law to get three years of full federal funding, no matter when the expansion starts.
“We're hoping to encourage more states to do the right thing,” Obama said.
The proposal will be included in the president’s 2017 budget blueprint. It would require congressional approval, which probably will be difficult given persistent GOP antipathy to the health law.
Congressional Republicans this month passed legislation, which Obama vetoed, that would have repealed large sections of the 2010 law, including the Medicaid expansion.
In Louisiana, Edwards may also face challenges to his move to expand the Medicaid program through executive action.
Edwards succeeded two-term Republican Gov. Bobby Jindal, who was an outspoken critic of Obama and specifically the health law during his brief and unsuccessful bid for the 2016 GOP presidential nomination.
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