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Bill Monning

SANTA CRUZ - A key state lawmaker on health care policy said Friday he believed many states now forcefully rejecting an expansion of government-funded health care for the poor would reverse course after the upcoming presidential election.

"My guess is that after November, you're going to see some states that are hollering now - no Obamacare, no Medicaid expansion - I don't see how they can afford not to, unless they're just going to say, 'We don't care about poor people in our state, we're going to let them fend for themselves," said Bill Monning, a Carmel Democrat who chairs the Assembly Committee on Health.

California was the first state to agree to a vast expansion of Medicaid under the Affordable Care Act, which was upheld last month by the U.S. Supreme Court. But the court held that states could not be forced to adopt the expansion, which requires states to pick up 10 percent of the tab after three years.

Conservative governors in several Southern states, including Texas and Florida, have rejected the expansion, saying it would cost too much. States rejecting the expanded coverage typically have higher numbers of uninsured residents.

Monning said all 50 states have opted into a federal program called the State Children's Health Insurance Program. Despite the state's persistent budget woes, Monning, who is heavily favored to win an open Central Coast Senate seat, said the state would follow through with the expansion.

"We'd better figure out a way to come up with the 10 percent, because a 9 to 1 match is pretty much unprecedented," Monning said.

In a visit with the Sentinel's editorial board that touched on several topics, Monning spoke about the aftermath of the ruling. Among the Legislature's task in preparing for the bill is a pending Monning bill that outlines what services public and private heath insurance is required to cover.

The Affordable Care Act outlines several areas of required coverage for health plans. But the details are left up to each state, and Monning patterned his bill after the Kaiser small group plan, which goes beyond common coverage areas to include acupuncture and costly therapeutic autism treatments.

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Monning predicts states to reverse course on Medicaid rejection