Medicaid expansion has become a key political issue under the Affordable Care Act (ACA), commonly known as Obamacare.
In 2012, the Supreme Court control Leaves it up to states to decide whether to adopt the ACA expansion. In the 10 years since then, 10 states have yet to expand Medicaid.that When translated More than 2 million people do not have health insurance amid the “coverage gap” created by the Supreme Court’s ruling.
Here’s how the disparity occurs: To qualify for Medicaid, an individual cannot earn more than 138%. federal poverty level, which currently equates to $20,120 in income. But only under the ACA expansion. The standard for subsidies under traditional insurance plans under the Affordable Care Act is income above 100% of the federal poverty level.
As a result, more than 2 million people not only live in poverty but are also ineligible for financial assistance.
“The plight of these people is truly terrible,” Shelley Glide, dean and professor at New York University’s Robert F. Wagner School of Public Service, told Yahoo Finance. “Imagine someone saying to you, “He can work 10 more hours this week, and if he works 10 more hours, he will lose his health insurance coverage.” “That’s strange. ”
a new report A Commonwealth Fund report co-authored by Glide found that the majority of these people in the coverage gap are people of color and live in the South, where most non-expansion states are located. is highlighted. In previous research, found The size of a state’s black population predicts whether the state will expand Medicaid. Glide said states with particularly large black populations are the ones that don’t.
“These people are particularly disadvantaged because they have no recourse,” Greed said. “They don’t have anywhere to go to get health insurance. There’s no way they can buy health insurance on the open market. They don’t have enough money and they don’t qualify for Medicaid. And this is called the ‘gap population.’ It’s a group. ”
“Strong political stance”
One of the most notable effects of Medicaid expansion was a significant increase in health insurance coverage.
The report, which compares outcomes for people likely to fall into the coverage gap in states that expanded Medicaid and comparable states that did not, found that parental coverage increased by 15.3% in expansion states. However, the insurance participation rate for non-parents increased by 10.5%.
“These improvements in coverage have reduced the rate at which financial considerations impede access to treatment,” the report states.
With the expansion of insurance coverage, fewer people avoid visiting medical institutions due to cost. Additionally, the rate of regular check-ups has improved, and regular contact with family doctors has increased.
The report also found that increased access and affordability of preventive care has increased the use of these services. For example, the report found that parents were 2.8% more likely to receive a flu shot and individuals were 6.7% more likely to receive a mammogram. People in the dilated state were 1.9% more likely to take medication to treat high blood pressure.
Although research shows that access to preventive care is financially beneficial, many state governments still resist expanding Medicaid, especially since the federal government covers up to 90% of Medicaid costs. Glide blames this on partisanship.
“This is really just a political point being made by these states,” Glide said. “Movement was very slow.” [but] state [will] Please know that the Affordable Care Act is here to stay. ”
“Challenging conundrum”
Expanding Medicaid is also an issue on the ballot for voters. In particular, voters in red states like Arkansas and Nebraska have overwhelmingly supported expansion in recent years. Ten states led by Republican governors continue to deny federal funding to the program.
Glide said it could take longer for more states to fully commit to this.
“What I think is going to happen in the near future is that state legislators will continue to use the Affordable Care Act to reduce the amount of federal tax money used to fund Medicaid expansion in states like California, New York, and Massachusetts. It’s about realizing that they’re paying, which they don’t really like, but not in their own state,” Greed said.
Coverage could become even more difficult after a pandemic-era law, the Families First Coronavirus Response Act, expires. Created Continued enrollment in Medicaid in all states. This program expired on March 31, 2023.
For example, Glide says, “If you’re in Texas and your income falls below the threshold, you’re going to be kicked out right away. So in non-expansion states, when the continuing coverage provisions end, a lot of people will be left uninsured.” You see, in expansion states, you don’t really expect that many people to be insured. Many of them will be uninsured.”
In the data It is shown Medicaid expansion has improved premium rates for all racial groups, nearly doubling in all categories. But Glide said there are “difficult challenges” for the Biden administration. Much of the cost of Medicaid expansion is already being paid for by the Biden administration, and Republican governors say they are unlikely to make political concessions.
“There’s a real question of how do we attract states that didn’t accept this really good offer? Do we want to offer them more? That doesn’t seem very right and I don’t think it’s fair. So it’s a difficult question,” Greed said. said. The challenge is how do you cover those people if the state doesn’t want it? ”
Adriana Belmonte is a reporter and editor covering politics and health policy at Yahoo Finance. You can follow her on Twitter @adrianambells Please contact [email protected].
