Study Finds Coverage Issues in States That Do Not Expand Medicaid
As many as 40% of low-income individuals who live in states that opt not to expand their Medicaid programs under the Affordable Care Act will be left with no new coverage options, according to a study by the Commonwealth Fund, The Hill's "Healthwatch" reports (Viebeck, "Healthwatch," The Hill, 9/5).
The report was based on a survey of 1,317 U.S. adults between ages 19 and 64 (Block, Modern Healthcare, 9/5).
Under the ACA, U.S. residents with incomes up to 138% of the federal poverty level are eligible for Medicaid. However, the U.S. Supreme Court last year ruled that states could opt out of the expansion. For states that opt in, the federal government will cover 100% of the cost of the expansion until 2016, after which the federal share will decline gradually until it reaches 90% in 2020 (California Healthline, 8/7).
The ACA offers subsidized coverage to individuals with incomes between 100% and 399% of FPL, assuming that anyone living under that level would qualify for Medicaid under an expansion.
However, nearly half of states have not yet opted to expand their Medicaid programs. Sara Collins -- a co-author of the report -- said low-income individuals in such states "will continue to experience periods without coverage and are at risk of having no new affordable options ... if their income falls below poverty."
The report notes that in 2011, nearly 30% of people with incomes between 100% and 133% of federal poverty level had their incomes fall below FPL in 2012.
The findings illustrate "why it is critical for states to fully explore the benefits of participating in the law's Medicaid expansion," according to the report (Kim, CQ HealthBeat, 9/5).
Although some states might eventually decide to participate in the ACA's Medicaid expansion, the researchers said that in the meantime lawmakers should ensure subsidized coverage is available to individuals living below the poverty line in states that do not expand their Medicaid programs. "This would ensure that all Americans have access to the law's sweeping new reforms when they take effect in January," the study states ("Healthwatch," The Hill, 9/5).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.