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Tag Archives: Medicaid

How Medicaid Expansion Can Help a State’s Economy

The U.S. Supreme Court ruled in 2012 that states can choose whether to expand their Medicaid programs under the Affordable Care Act (ACA), or Obamacare. To date, 32 states have decided to do so, finding that ultimately it would be beneficial to them. Studies, furthermore, show that the states opting out of Medicaid expansion are actually losing billions of dollars, thus reducing job growth and economic activity.

In 1965, President Lyndon B. Johnson signed into law Medicaid, a program jointly administered by the federal and state governments to provide free medical care to low-income Americans. Many Republicans consider it a form of welfare, an anathema to their traditional ideology that centers on limited government and fewer regulations and taxes to spur job growth.

Many claim that since taxpayers’ dollars fund Medicaid, rolling back the program would help the economy by saving taxpayers money. But, in what economists call “a multiplier effect,” it becomes evident that Medicaid expansion actually saves the states money.

The multiplier effect applies in this context to the money generated from the funds the federal government gives the states to expand their Medicaid programs. Some of the money goes to healthcare workers, who then spend their money on things like homes, restaurants, and theaters. This generates additional revenue, which then goes into the states’ coffers in the form of taxes.

When states decide against Medicaid expansion, they risk putting hospitals and clinics in financial jeopardy when uninsured people become unable to pay their medical bills. Also, when an uninsured person needs to see a doctor, they may end up going to the emergency room instead, in which case the hospital won’t turn them away. As John Holohan, a fellow at the Urban Institute, said, “You can’t make an economic case against expansion.”

For more information on Medicaid expansion, please contact us.

Finding the Medicaid Options That Work For You

Medicaid enrollment swelled following the passage of the Affordable Care Act. From 2013 through September 2016, the Kaiser Family Foundation counts a net increase of 15.7 million enrollees in both Medicaid and the children’s health insurance program CHIP. This growth occurred as some states expanded Medicaid eligibility, which brought beneficiaries into the program. The expansion, financially supported by the federal government, was envisioned as a way to meet the ACA’s goal of making some form of health insurance available to more Americans, particularly those with low incomes. Changes to Medicaid might be coming, but those changes don’t have to mean that people will lose access to the program altogether.

With more adults covered by Medicaid, some states saw economic gains in the form of savings, revenue growth for healthcare providers, or overall economic growth. The Medicaid expansion also played a large role in reducing uninsured rates. The rate of non-elderly Americans who are not covered by health insurance fell to a record low of 10 percent in early 2016, Kaiser Family Foundation said.

The change in political power in Washington, D.C., has sparked questions about the future of Medicaid. Repeal of the ACA was among the top the proposals of Donald Trump during the presidential campaign. Any changes to the ACA could change the eligibility requirements for Medicaid. If states return to the eligibility requirements that they had prior to the ACA’s passage in 2013, many adults could lose Medicaid eligibility in the states that had expanded coverage, according to the Kaiser Family Foundation. The foundation also says that changes to the ACA could reverse the trend of declining rates of uninsured people, particularly those who are Medicaid recipients.

While health policy changes appear to be coming, it’s important to note that Medicaid is not a one-size-fits-all program. Private health insurance and Medicaid can work together to help people cover their healthcare needs. Medicaid coverage is based on financial need, meaning that beneficiaries need to show that they can’t afford their monthly insurance premiums. But with demonstrated financial need, people who have private insurance coverage can also secure monthly premium support through Medicaid.

There are different paths that people can take to secure the insurance coverage that they need. For help navigating your health insurance options, please contact us.

How Does Medicaid Work?

Medicaid is the health care system in the United States that provides coverage for certain low-income, blind and disabled people.  Medicaid is funded by both federal and state dollars, and every state has different rules about who is eligible and which services are covered.  Since 1982, all 50 states have participated in Medicaid, and many of them have expanded Medicaid coverage since the launch of the Affordable Care Act (Obamacare) in 2010.

The majority of Medicaid services in most states are provided at no cost to the recipient; payment is made directly by the state to the doctors, pharmacies, hospitals and ancillary providers on behalf of the person being treated. In some states there are small cash co-pays for some services.

To find out what benefits and services are covered by Medicaid in your state, the client must work directly with the local benefits office to enroll. Medicaid is typically handled in the same office where other public assistance programs like SNAP (food stamps), job training assistance and cash assistance are administered, often at the county level.

Applying for Medicaid requires submission of a paper or computerized form describing the client’s financial situation, including place of residence and personal/household income and expense scenarios. Claims made on the application must be verified with supporting documentation: lease, pay stubs, copies of bills, etc.

Once the application is completed, there will be a waiting period until it is approved; the local benefits office can estimate how long this will be when they accept the completed application. Upon approval, a Medicaid card will be sent to the applicant.  In some states, Medicaid care will be coordinated by a separate Managed Care Organization (MCO); if this is the case, a separate medical card for the MCO will also be mailed to the applicant. This is the card to be presented at medical appointments and when picking up prescriptions.

Medicaid eligibility must be verified at regular intervals and whenever a recipient’s income, household or expense situation changes.  If eligibility is terminated, the Medicaid and/or MCO cards will no longer be accepted by doctors and other providers.  For this reason, it is important attend all scheduled appointments with the local benefits office and to bring all relevant documentation. If Medicaid is not approved and there is reason to believe that an error has been made, there are appeals procedures available.

Because Medicaid has different rules in every state, benefits only apply in the state where they are applied for and approved.  If a recipient moves across a state line, benefits will not be available until the old state’s Medicaid has been terminated and a new application has been approved.

For individuals who qualify for Medicaid, it is the most cost-effective and accessible plan available.  Now that many states have expanded their Medicaid eligibility guidelines as part of the ACA, individuals who previously would have been limited to a commercial policy may now be Medicaid eligible.  For those who lose their Medicaid eligibility due to improved employment or other status changes, an NHIA agency may be able to assist with locating the best plan for continued, affordable coverage.