Health Policy 101: Medicaid Expansion – What is it, how was it affected, and what will its impact be on the health care system?
Medicaid is the country’s health insurance program for low-income and vulnerable populations. Medicaid provides health coverage to about 60 million Americans, including pregnant women, elderly and more than 31 million children. The federal government sets minimum guidelines for Medicaid eligibility but states can choose to expand coverage beyond the minimum threshold, which is typically determined by a percentage of the federal poverty level.
Within the ACA, there was a provision that would require states to expand Medicaid coverage in 2014 to a minimum threshold of 133% of the federal poverty level (approximately $31,000 a year for a family of four). This expansion would provide access to health insurance for an additional 17 million Americans. For the first two years, the federal government would pay for 100% the costs of this expansion, but in subsequent years federal government’s contribution would drop as low as 90% and the state would have to pay for the rest.
A controversial part of the ACA’s Medicaid expansion was that the federal government would have the ability to withhold all Medicaid funding to states if they did not fully comply with the expansion. Justice Roberts’ decision deemed this provision unconstitutional, indicating that this “financial ‘inducement’… is economic dragooning that leaves the States with no real option but to acquiesce in the Medicaid expansion." As a result, the federal government can no longer use this measure of withholding funds to make states participate in the Medicaid expansion.
The results of this decision appear unclear. The court ruling allows the states the option to not participate in the Medicaid expansion without having to face the threat of losing entire Medicaid funding from the federal government. This could lead certain states which are facing budget restraints to consider not participating in the Medicaid expansion due to their inability to afford the costs after the federal government would reduce their funding in 2016. This could potentially leave affordable health insurance out of reach for millions. Other forces, however, could compel states to take part in the expansion, such as advocacy from interest groups focused on the health status of low-income families, hospital organizations, or incentives from the federal government.
For physicians and hospitals, this could impact the insurance status of their patient populations. Organizations such as the AAMC is continuing to closely examine the court’s ruling on the Medicaid expansion and how it will affect academic medical colleges throughout the country.
Source: http://www.kaiserhealthnews.org/Stories/2012/June/28/supreme-court-upholds-individual-mandate.aspx
Your loyal Legislative Affairs team,
Brad Hunter – Northeast Region
Robert Sanchez – Central Region
Sean Vanlandingham – Southern Region
Claire Sadler – Western Region
William Teeter – National Delegate
More "Heath Policy 101" articles on the official OSR Legislative Affairs website
Medicaid is the country’s health insurance program for low-income and vulnerable populations. Medicaid provides health coverage to about 60 million Americans, including pregnant women, elderly and more than 31 million children. The federal government sets minimum guidelines for Medicaid eligibility but states can choose to expand coverage beyond the minimum threshold, which is typically determined by a percentage of the federal poverty level.
Within the ACA, there was a provision that would require states to expand Medicaid coverage in 2014 to a minimum threshold of 133% of the federal poverty level (approximately $31,000 a year for a family of four). This expansion would provide access to health insurance for an additional 17 million Americans. For the first two years, the federal government would pay for 100% the costs of this expansion, but in subsequent years federal government’s contribution would drop as low as 90% and the state would have to pay for the rest.
A controversial part of the ACA’s Medicaid expansion was that the federal government would have the ability to withhold all Medicaid funding to states if they did not fully comply with the expansion. Justice Roberts’ decision deemed this provision unconstitutional, indicating that this “financial ‘inducement’… is economic dragooning that leaves the States with no real option but to acquiesce in the Medicaid expansion." As a result, the federal government can no longer use this measure of withholding funds to make states participate in the Medicaid expansion.
The results of this decision appear unclear. The court ruling allows the states the option to not participate in the Medicaid expansion without having to face the threat of losing entire Medicaid funding from the federal government. This could lead certain states which are facing budget restraints to consider not participating in the Medicaid expansion due to their inability to afford the costs after the federal government would reduce their funding in 2016. This could potentially leave affordable health insurance out of reach for millions. Other forces, however, could compel states to take part in the expansion, such as advocacy from interest groups focused on the health status of low-income families, hospital organizations, or incentives from the federal government.
For physicians and hospitals, this could impact the insurance status of their patient populations. Organizations such as the AAMC is continuing to closely examine the court’s ruling on the Medicaid expansion and how it will affect academic medical colleges throughout the country.
Source: http://www.kaiserhealthnews.org/Stories/2012/June/28/supreme-court-upholds-individual-mandate.aspx
Your loyal Legislative Affairs team,
Brad Hunter – Northeast Region
Robert Sanchez – Central Region
Sean Vanlandingham – Southern Region
Claire Sadler – Western Region
William Teeter – National Delegate
More "Heath Policy 101" articles on the official OSR Legislative Affairs website