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Urban paper examines how many adults would remain uninsured if states opt out of Medicaid expansion

Posted on July 10, 2012 | No Comments

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The Supreme Court’s ruling on the Affordable Care Act (ACA) upheld the individual mandate and made the expansion of Medicaid coverage to nonelderly adults with incomes below 138 percent of the federal poverty level optional for states. In a new brief, authors from the Urban Institute estimate the number of uninsured Americans in each state who could be eligible for Medicaid if every state takes advantage of the option of expanding Medicaid coverage. According to the report, almost half of the nation’s uninsured could qualify for Medicaid under the ACA. Of 22.3 million low-income uninsured Americans who could be potentially eligible for Medicaid under the ACA, 67 percent (15.1 million) are adults not currently eligible for Medicaid. Of this group, 11.5 million have incomes below poverty and would not qualify for any other subsidized coverage.

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A new study by the Urban Institute funded by the Robert Wood Johnson Foundation finds that two-thirds of the nation’s remaining uninsured adults have incomes at or below 138 percent of the federal poverty level (FPL). While this is the target population of the Affordable Care Act’s (ACA) Medicaid expansion, 40 percent of the uninsured live in states that chose not to expand Medicaid. The study found that affordability was the main reason people did not get health insurance, yet many uninsured individuals had limited awareness of potential financial help available to them.
A new study released by the Robert Wood Johnson Foundation and Urban Institute describes the financial burden of medical spending on a state-by-state basis. Using this information, the study hones in on the number of individuals per state that experience high burdens from medical spending, yet currently are not eligible for Medicaid. The study found that Medicaid expansion, under the Affordable Care Act (ACA), has the potential to mitigate the financial burden from medical spending for several vulnerable populations in various regions across the country.
A new report from the Robert Wood Johnson Foundation's State Health Access Data Assistance Center details the number of individuals estimated per state to be excluded from Medicaid coverage after implementation of the Affordable Care Act (ACA). Despite the vast increase in individuals that will gain access to insurance due to the ACA, there remain a large number of non-elderly, low-income adults that will still not be eligible for coverage, even in states that expand Medicaid. The basis for this exclusion is immigration status, as legal permanent residents, under most scenarios, remain ineligible for coverage for the first five years in which they legally reside in the US. Unauthorized immigrants are completely barred from receiving Medicaid.
A report recently released by the Robert Wood Johnson Foundation (RWJF) serves as a guide for states considering Medicaid expansion in the wake of the U.S. Supreme Court decision. The analysis in the RWJF report is limited to financial considerations related to a state’s decision to expand and therefore does not include many financial aspects related to the Affordable Care Act (ACA) as a whole (remaining mandatory provisions, for example). There are six main areas of financial analysis that all states should consider that are included in this report: 1. Cost of newly eligibles 2. Cost of currently eligible but not enrolled 3. Administrative costs 4. Savings from transitioning current Medicaid populations to newly eligible group 5. Savings from reduction in state programs for the uninsured 6. Other revenue gains and savings.
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A report recently published by the Robert Wood Johnson Foundation in collaboration with State Health Access Data Assistance Center analyzes recent trends in health insurance coverage for children at the state level between 2008 and 2010. The percentage of children with public coverage through Medicaid or the Children’s Health Insurance Program (CHIP) increased substantially, while rates of private coverage and uninsurance declined. However, the report found substantial variation across states. The main findings of this report include the following...
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The Internal Revenue Service (IRS) and the Centers for Medicare and Medicaid Services (CMS) have released 2 new proposed rules related to the individual requirement to purchase health insurance (mandate). The IRS rule clarifies the requirement that nonexempt individuals maintain minimum essential coverage or make a shared responsibility payment (penalty). The CMS rule lays out specific exemptions to minimum coverage requirement, most notably that any person otherwise eligible for Medicaid under the new ACA eligibility expansion, but who resides in a state that has chosen not to expand, will not be subject to the shared responsibility payment. Stay tuned to HealthReformGPS for a detailed analysis of these rules in the future.
On December 10, 2012, the Centers for Medicare and Medicaid Services (CMS) released a long-awaited set of frequently asked questions on Exchanges, market reforms, and Medicaid. We will post a further analysis of these FAQs in the near future, but we rush to post one question and answer because of its significance in relation to the Medicaid expansion...
On December 10, 2012, the Centers for Medicare and Medicaid Services (CMS) released a long-awaited set of frequently asked questions on Exchanges, market reforms, and Medicaid. We will post a further analysis of these FAQs in the near future, but we rush to post one question and answer because of its significance in relation to the Medicaid expansion...