Governor McAuliffe

Several so-called “red states” are leaning toward or have outright abandoned plans to allow expansion of their Medicaid programs, bucking a nationwide groundswell of program enrollment under the president’s signature healthcare reform law.

Wyoming became the latest state to reject plans to expand its Medicaid program via provisions offered under the Affordable Care Act. On February 19, lawmakers there defeated a bill that would have allowed it, with many expressing mistrust that the government could keep up with scheduled Medicaid payments under an expansion that could have added more than 17,000 low-income residents to the program’s rolls.

The next day, Kansas entered the doubtful column after House Health and Human Services Committee Chair Rep. Dan Hawkins (R-Wichita) told reporters he did not plan on scheduling hearings on three different bills allowing Medicaid expansion in that state.

Twenty-nine states had formally adopted Medicaid expansion plans as of Tuesday; the rest have either outright rejected adoption or are still considering it, according to the Henry J. Kaiser Family Foundation.

Tennessee had been moving closer to approving expansion, but Senate lawmakers there roundly defeated an expansion bill earlier this month.

Virginia Gov. Terry McAuliffe (D) last September used executive order powers to add 25,000 new uninsured people to the state’s Medicaid rolls, anticipating his state would formally reject future Medicaid expansion plans, which it has.

Indiana in late January convinced the Obama administration to allow it to expand its Medicaid rolls with a series of novel conditions surrounding personal responsibility.

Medicaid expansion plans are still being debated in Utah.

Meanwhile, Medicaid program enrollment has been exponentially growing under the ACA. This week, the Obama administration announced that more than 10 million Americans have joined the Medicaid program since it rolled out in 2013. Medicaid enrollment rose 27% in 2014 among states accepting program expansion, according to the White House.

On Tuesday, the administration announced that more than 11 million Americans signed up for health insurance coverage under the ACA in 2015, exceeding previous projections by more than 2 million.