The cost of not expanding Medicaid
- Collection:
- Health Policy and Services Research
- Author(s):
- Holahan, John, author Buettgens, Matthew, author Dorn, Stan, author
- Contributor(s):
- Henry J. Kaiser Family Foundation, issuing body. Kaiser Commission on Medicaid and the Uninsured, issuing body.
- Publication:
- Menlo Park, CA : Henry J. Kaiser Family Foundation, July 2013
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Health Care Reform -- economics Health Care Reform -- legislation & jurisprudence Health Care Reform -- statistics & numerical data Insurance Coverage -- economics Insurance Coverage -- legislation & jurisprudence Insurance Coverage -- statistics & numerical data Insurance, Health -- economics Insurance, Health -- legislation & jurisprudence Insurance, Health -- statistics & numerical data Medicaid -- economics Medicaid -- legislation & jurisprudence Medicaid -- statistics & numerical data Medically Uninsured -- legislation & jurisprudence Medically Uninsured -- statistics & numerical data United States United States.
- Genre(s):
- Technical Report
- Abstract:
- As states wrap up legislative sessions and make decisions about whether to implement the Medicaid expansion included in the Affordable Care Act (ACA), this new analysis highlights the implications of these decisions for coverage, state finances and providers. As of July 2013, 24 states were moving forward with the Medicaid expansion, 21 states were not moving forward with the expansion and debate was on-going in the remaining 6 states. The decisions by as many as 27 states not to adopt the Medicaid expansion will leave a major hole in the health reform effort. Key finding from this analysis include: (1) There would be fewer people enrolled in Medicaid and many more uninsured. Nearly two-thirds of those who were originally expected to be covered by the Medicaid expansion are in these 27 states. As many as 6.4 million uninsured will not be covered if all 27 states do not adopt the Medicaid expansion. Texas, Florida and Georgia account for half of the uninsured in the states not moving forward. (2) The 21 states that are not expanding Medicaid would forgo $35 billion in federal funds in 2016 and $345.9 over the 2013 to 2022 period while the 6 states still currently debating would forgo $15.2 in 2016 and $151 billion over the 2013 to 2022 period. These states would have experienced larger percentage increases in federal funds relative to the states moving forward with the expansion. (3) For states that move forward with the expansion, reductions in uncompensated care costs help to mitigate increases in state costs or increase estimated savings. There are also many other state specific offsetting savings due to the expansion that could result in net benefits. These vary state to state and cannot be included in this analysis which uses national data sets. (4) For states that move forward with the expansion, increases in federal funding will greatly outweigh any potential increases in state expenditures and will have positive economic effects, increasing employment and state general revenues. (5) The decision not to adopt the Medicaid expansion will create inequities in coverage. Those with incomes below 100 percent will not be eligible for subsidies in exchanges or for Medicaid coverage beyond current eligibility levels. This leaves considerable gaps in coverage and will also result in substantially less revenue for hospitals. Under the ACA, hospitals in these states will still face cutbacks in Medicare and Medicaid disproportionate share hospital payments as well as lower Medicare payment rates independent of whether or not a state adopts the Medicaid expansion. And they will still be faced with serving a large uninsured population. Based on this analysis we conclude that the economic case for Medicaid expansion for state officials is extremely strong.
- Copyright:
- The National Library of Medicine believes this item to be in the public domain (More information)
- Extent:
- 1 online resource (1 PDF file (21 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101613455 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101613455