Study: Most Medicaid-eligible Americans will be excluded from expansion

The vast majority of those eligible for Medicaid under the program expansion included in the Affordable Care Act will not wind up in the program under current circumstances, according to the Kaiser Commission on Medicaid.

As a result, providers--including hospitals--could lose out on on hundreds of billions of dollars in payments over the next decade.

A new report issued by the Kaiser Commission concluded that as many as 27 states will not expand their Medicaid programs to cover those earning up to 138 percent of the federal poverty level. Twenty-one of those states have already rejected expansion, while six others are still debating the issue. Residing in those states are more than 60 percent of Americans who would be eligible for the expansion.

The reluctance of the states to participate in the program has been exacerbated by the fact that many outreach groups lack funding for appropriate outreach programs.

The Boston Globe, in reporting on the difficulties in expanding Medicaid in portions of New England, has concluded that "healthcare access is becoming highly dependent on where you live."

According to the report, the 21 states that have already opted not to expand Medicaid would leave $35 billion in Medicaid funds on the table in 2016, and $345.9 billion over the next decade. And the six states still debating Medicaid expansion stand to lose $15.6 billion in 2016 and $151 billion over the next decade.

"This leaves considerable gaps in coverage and will also result in substantially less revenue for hospitals," the report said.

To learn more:
- read the Kaiser Commission study (.pdf)
- check out The Boston Globarticle

 

Suggested Articles

Presidential candidate Kamala Harris wants to get rid of the tax break drug companies get for DTC ads

Healthcare software company Phreesia closed its first day of trading as a public company Thursday about 40% above its set price.

Growing the biosimilar market could lead to significant healthcare cost savings, according to a new report.