# Understanding the Medicaid REACH Act

This bill creates financial penalties for states that haven't expanded Medicaid and refuse to report information about their uninsured populations. Specifically, it targets the roughly a dozen states that have chosen not to expand Medicaid eligibility under the Affordable Care Act, requiring them to publicly share detailed data about how many people lack health insurance and how many would qualify for coverage if the state expanded the program.

Here's how it works in practice: Starting in 2022, states that don't expand Medicaid must post specific information on their websites by January 1st each year, including the number of uninsured residents (broken down by race, ethnicity, gender, and age), how many of those people would qualify for Medicaid if the state expanded, current income limits for different Medicaid groups, and hospital costs related to uncompensated care. States must also allow 30 days for public comment and submit everything to the federal government by March 1st. If a state fails to do this, it loses federal funding for certain administrative costs—starting with a 0.5 percentage point reduction in April, increasing to 1.0 percentage point by July, and reaching 1.5 percentage points by October. However, states can avoid these penalties by complying with the reporting requirements at any point during the year.

The bill essentially uses financial pressure to force transparency. By requiring states to publicly document their uninsured populations and the potential impact of Medicaid expansion, it aims to create political pressure for states to reconsider their decisions not to expand coverage. The reporting requirements also give the federal government and the public concrete data about the human and financial costs of non-expansion, potentially influencing future policy decisions.

Medicaid REACH Act

Doggett, Lloyd

Medicaid Report on Expansion of Access to Coverage for Health Act or the Medicaid REACH Act This bill reduces federal payment for Medicaid administrative expenses incurred by states that have not elected to participate in Medicaid expansion under the Patient Protection and Affordable Care Act (i.e., nonexpansion states) if the state does not comply with specified reporting requirements. The bill requires nonexpansion states to report, among other information,&nbsp;the number of uninsured individuals under the age of 65 and the estimated percentage of such individuals who would be eligible to receive coverage if the state expanded Medicaid.