Currently, Medicaid eligibility includes some disabled individuals, parents with incomes below welfare eligibility, some low income children, and pregnant women under 133% of the federal poverty level (FPL).
Under the Affordable Care Act (ACA), starting January 2014, Medicaid coverage will be expanded to include all individuals, regardless of children or disability, whose income is up to 133% of the poverty level. Several states are refusing to implement the Medicaid expansion, while other states are complying with the ACA.
What impact will the refusal of some states to implement Medicaid have on healthcare delivery and outcomes?
Kameron Sheats, PhD says…
“States’ refusal to expand Medicaid will serve to maintain the status quo of underinsured and uninsured citizens and abysmal disparities in healthcare. Instead of reaping the benefits of government-funded expansion programs, those in need will continue to strain the economic system through lost productivity at work and school, and ultimately more serious health consequences requiring secondary and tertiary care. Furthermore, refusal of some states could precipitate a chain reaction in which other states see Medicaid expansion as dispensable when government funding for expansion is reduced. States who had previously expanded Medicaid may be more likely to cut this program first if in an economic bind because ‘other states are doing just fine without expansion.’ This potential sequence of events could undermine the entire expansion program and all of its benefits for citizens across America.”
Jammie Hopkins, DrPH, MS says…
“Refusal to implement Medicaid expansion may prevent up to six million of the most medically vulnerable Americans from receiving health insurance benefits over the next 10 years. If states refuse Medicaid without making provisions to cover their uninsured populations, disparities in health outcomes between the uninsured and insured will grow. Uninsured populations will continue to delay medical care, opt out of preventive care, and suffer financial vulnerabilities in an attempt to afford to stay healthy. Healthcare delivery will suffer as a result, as the uninsured will continue to rely on already strained safety net providers and emergency [providers] for standard care and emergency care.”
[ These comments appear courtesy the Health Policy Leadership Fellows at the Satcher Health Leadership Institute at the Morehouse School of Medicine. Dr. Renée Volny, a Policy Prescriptions ® contributor, currently serves as interim associate director of the Fellowship and has encouraged her Fellows to engage in discussions on current health policy topics. The best discussion points put forth will be featured on our site. ]