"Opting Out Of Medicaid Expansion: The Health and Financial Impacts"

[applegrove]

Opting Out Of Medicaid Expansion: The Health and Financial Impacts

by Sam Dickman, David Himmelstein, Danny McCormick, and Steffie Woolhandler at Health Affairs Blog


http://healthaffairs.org/blog/2014/01/30/opting-out-of-medicaid-expansion-the-health-and-financial-impacts/

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The Supreme Court’s decision to allow states to opt out of Medicaid expansion will have adverse health and financial consequences. Based on recent data from the Oregon Health Insurance Experiment, we predict that many low-income women will forego recommended breast and cervical cancer screening; diabetics will forego medications, and all low-income adults will face a greater likelihood of depression, catastrophic medical expenses, and death. Disparities in access to care based on state of residence will increase. Because the federal government will pay 100 percent of increased costs associated with Medicaid expansion for the first three years (and 90 percent thereafter), opt-out states are also turning down billions of dollars of potential revenue, which might strengthen their local economy.

The ACA’s tax subsidy for insurance purchase on the Exchanges is only available to persons with incomes above 100 percent of FPL. People below this threshold in opt-out states (the so-called low-income “coverage gap”) will see no benefit as the law goes into effect. They may even see harm because the ACA cuts disproportionate share (DSH) funding to safety net hospitals, reducing the resources available to care for the remaining uninsured.

Despite the widely held belief that almost all Americans will be insured under the ACA, more than 32 million people will remain uninsured after the law goes into effect. Even in states that opt in to Medicaid expansion, millions will remain without coverage.

Low-income adults in states that have opted out of Medicaid expansion will forego gains in access to care, financial well-being, physical and mental health, and longevity that would be expected with expanded Medicaid coverage.





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[mike_c]

1. universal single payer health care for all....

There is only one solution.

[Barack_America]

2. Poor red states will get poorer...

...and their residents will remain screwed.

[applegrove]

3. There was an article yesterday - 9 out of the 10 US cities that are on the move

are in Blue states. How do you punch through to those people in red states? I hope Obama does if he gets interviewed by Bill O'Reilly. I hope he points out that Red states are not doing well under the GOP.

[blue neen]

4. There are also blue states who have idiots for Governors.

Pennsylvania is one of them. Tom Corbett has screwed Pennsylvanians every chance he got.

[Shandris]

5. Worse, the tax subsidy doesn't count in those states if they work and their workplace...

...offers insurance. They aren't eligible for the subsidies then, either. They have to take the work option. So yah, it's a real catastrophe for some people in those states -- my state.