How Health Reform Could Expand Medicaid

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PP-ACA Results State-by-State

By Lena Groeger

Experts estimate that nearly 16 million Americans could be added to the Medicaid rolls by 2019 under an expansion in the Affordable Care Act. But, the Supreme Court ruled last Thursday that states can opt out without risk of losing federal support for Medicaid, raising the stakes that some may do so.

The Big Picture

Here is a look at forecast growth in state Medicaid rolls under the expansion. Twenty-six challenged the act in court.


Related: Mystery After the Health Care Ruling: Which States Will Refuse Medicaid Expansion?


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3 Responses

  1. Most physicians today feel like they are continuously under the gun

    Now, what will the ACA do?



  2. Docs Won’t See Medicaid Patients – NJ Worst Reimbursement

    If you’re on Medicaid and looking for a new doctor, your chances are excellent of finding one … in Wyoming. In New Jersey, not so much.



  3. Medicaid enrollment

    Medicaid enrollment has increased almost 50% in the last 10 years, from 46.3 million in 2005 to a projected 68.9 million in 2015. By 2023, Medicaid is expected to reach almost 80 million people. As commercial health plans compete to gain greater enrollment, the increasing health care market share claimed by the federal government could create disruptions in the current balance of power. These shifts could affect the relative influence between private and public plans and between state and federal regulation of health insurance.

    The Affordable Care Act is the major factor behind the Medicaid growth, with the biggest jump of about 11 million taking place since the opening of the Marketplace in 2013. As the commercial health plans have seen that increasing enrollment is going to be key for their ongoing welfare, the Medicaid trend is one driver of the movement toward health plan consolidation. The section of the pie available for commercial plans is shrinking, leaving room for only a limited number of players.

    Earlier this year, states that have not implemented Medicaid expansion under the ACA received notice that federal Low Income Pool funds may not be renewed. Such funds help reimburse hospitals that provide uncompensated care for people who cannot afford it. This funding runs into the tens of billions of dollars. The Centers for Medicare and Medicaid Services may apply restrictions on how the funds can be used, (e.g, not reimbursing care to individuals who could have been covered if Medicaid was expanded). Less of this federal funding may also make health care providers less willing to participate in Medicaid, poking larger holes in the health care “safety net.” Some states have pushed back against the federal action and the governor of Florida has filed a lawsuit accusing the Department of Health and Human Services of coercion.

    The unusual market dynamic emerging from Medicaid’s rapid growth will affect all aspects of the health care delivery system, impacting the choices available to both individual and group purchasers, creating challenging decisions for providers and altering the public policy landscape.

    Henry Loubet via Ann Miller RN MHA
    [Chief Strategy Officer]


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