States Not Expanding Medicaid Eligibility is a SCARY Thought

Halloween is just around the corner and I’m pretty psyched about the arrival of haunted houses and scary movie marathons. I’m not easily scared. I will watch The Shining without flinching; I was thrilled about the new season of American Horror Story starting, and one of the first things I do when visiting a new city is look for a good ghost tour. One thing that does have me frightened though (other than the ridiculous lines at Party City the weekend before Halloween) is the prospect that some States may not expand Medicaid eligibility in 2014.

The Affordable Care Act extends health coverage to 30 million currently uninsured Americans through tax credits to purchase private insurance and a major expansion of Medicaid eligibility to all qualified individuals under age 65 who have incomes below 133 percent of the federal poverty line (FPL) (about $30,000 for a family of four). The Medicaid eligibility expansion accounts for approximately half of the coverage gains under the new healthcare law. This marks the first time in many states that low-income childless adults will have access to Medicaid coverage. In June, the Supreme Court held that states need not participate in the expansion of Medicaid eligibility in order to continue receiving current federal Medicaid funding. Under the Court's ruling, states will choose whether or not to cover the expansion population.

Not expanding Medicaid eligibility would be a raw deal for women, state budgets, and health care consumers. Here are just a few examples why:

• Low income women are four times more likely than higher income women to report fair or poor health and twice as likely to have a condition that limits their daily activities. In states that do not expand Medicaid eligibility, these women will have difficulty accessing the coverage they need to improve their health
• States that don’t expand Medicaid eligibility will end up spending more in the long-run on uncompensated care for uninsured individuals. The Urban Institute estimates that under the ACA, states could save between $26 and $52 billion in uncompensated care costs between 2014 and 2019.
• The American Academy of Actuaries has found that states that do not take up the Medicaid expansion could see higher premiums in the private market than states that do.

To find out more about the Medicaid eligibility expansion and why it is a good deal for women’s health, a good deal for states, and a good deal for healthcare consumers, take a look at our new issue brief.