Social workers urging lawmakers’ support in states that have opted out or are undecided.

The good news: The Affordable Care Act calls for expanding Medicaid eligibility in 2014 for nearly all U.S. citizens under 65 whose incomes are up to 133 percent of the federal poverty level.

The not so good news: The U.S. Supreme Court’s June 2012 ruling on the ACA allows states to opt out of the Medicaid expansion.

NASW chapters have been actively petitioning their state lawmakers in favor of the expansion, which has the potential to benefit millions of people.

According to the Henry J. Kaiser Family Foundation, on March 5, 27 states had declared they will accept the Medicaid expansion, 17 states said they will decline it and a handful of states had made no official decision. West Virginia falls into the latter category, and the NASW chapter there has been active in helping persuade state leaders of the many benefits of joining the expansion.

“We consider Medicaid expansion to be one of the most significant opportunities of our lifetimes to improve civil and human rights for low-income individuals and families,” said Sam Hickman, executive director of the NASW West Virginia Chapter. Medicaid expansion in the state would provide health insurance coverage for more than 120,000 low-income individuals and families, he said.

The chapter’s efforts include co-sponsoring an April 7 public forum on the topic. The event is a way to demonstrate public support for the measure to Gov. Earl Ray Tomblin, Hickman said.

“NASW West Virginia is a founding member of the Our Children, Our Future Campaign to End Child Poverty, which lists Medicaid expansion as its No. 1 priority,” he said.

In addition, they created a website that helps people determine whether they would be eligible for Medicaid under the expansion, and to express their support for expansion to the governor.

Hickman noted that expanding Medicaid will have a positive job and economic impact as well, creating up to 6,000 new jobs in West Virginia and bringing in billions of dollars of federal funds.

In Tennessee, however, the Medicaid expansion question took a different twist in late March.

Gov. Bill Haslam declared he would not accept federal funds for Medicaid expansion as other states have done, said Karen Franklin, executive director of the NASW Tennessee Chapter.

“He wanted to explore an alternative plan where federal funds could be used to purchase insurance for the Medicaid expansion-eligible population,” she said.

According to an article in the Tennessean newspaper, after the governor made his declaration, the Obama administration responded on March 29 that it would allow states to experiment with alternative approaches to the Medicaid expansion.

Before the governor made his decision, the NASW chapter sent him a letter, urging his support of the expansion, which would bring an estimated $6 billion in additional federal dollars to the state between 2014 and 2019. It’s estimated that an additional 181,700 people would be enrolled by 2019. The chapter is also a member of the Tennessee Coalition on Mental Health and Substance Abuse Services. The group held an advocacy day in March with the primary issue being Medicaid expansion.

Now that the governor has made his goals public, Franklin said the chapter will work with him to support his plan.

“We were pleased to learn that the federal government will consider ‘premium assistance’ demonstration projects that meet specific guidelines,” Franklin said. “We urge our state leaders to move quickly to develop a Tennessee pilot (program) that will provide health care coverage for those with incomes below 138 percent of the poverty level.”

In Wisconsin, social workers and health care advocates have a greater challenge.

Gov. Scott Walker said Wisconsin will not join the Medicaid expansion. The state has also declined to run its own health exchange, defaulting to federal control.

NASW Wisconsin Chapter Executive Director Marc Herstand said the governor’s Medicaid decision will not go down without a challenge to state lawmakers to overturn it.

In an effort to facilitate a change, the chapter is a coalition member of Wisconsin Citizens Action, which is encouraging its members to call on their legislators to accept the Medicaid expansion.

“A lot of people will not have health insurance because of the decision not to expand Medicaid,” Herstand said. “We will be having a lobby day in April and this is one of the issues we will be talking about. We’ve also been attending meetings on it.”

According to the Center on Budget and Policy Priorities, If Wisconsin expands Medicaid, an additional 211,000 adults will be eligible for the program.

Wisconsin Citizens Action said the governor’s decision will reject billions of dollars in federal health care reform funds to the state.

“This decision endangers lives and denies needed funds to Wisconsin communities,” the coalition states on its website, citizenactionwi.org. “Access to affordable health care is a necessity in modern society and families without it do not have a fair shot at the American dream! Don’t let Walker take affordable health care coverage away from Wisconsin families!”

Get more information: Affordable Care Act Integration.