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Medicaid Expansion

Governor of Maine Denies Healthcare for 70,000 Mainers

Last week, Governor LePage blocked health coverage to hardworking Maine residents by vetoing a bill that would have provided Medicaid to 70,000 people.

Maine is one of 24 states that have not taken federal funding to cover more people in Medicaid. Under the health care law, women and their families in every state are eligible for tax credits to help them afford health insurance, depending on their family income. In states that accept federal money to expand coverage through Medicaid, people with lower incomes will also have affordable coverage. But in states that turn down the money, people with lower incomes (and those who do not meet other strict eligibility criteria) will not get any financial help for health insurance costs. That’s the “coverage gap” too many women and families are facing right now. Read more »

Making Insurance Work for Seven Million and Counting

In case you haven’t heard – over seven million Americans have enrolled in private health insurance thanks to the Affordable Care Act (ACA). The numbers are still coming in, so this number will continue to grow as state-based Marketplaces as well as Medicaid and CHIP enrollment is added up. The numbers alone tell a great success story, but some news reports are quibbling about whether these numbers reflect previously uninsured Americans or people choosing to switch plans.

The goal of the health care law is to ensure that everyone has access to high-quality health insurance that fits their budget. Before the law, many people didn’t have any health insurance and others – women, in particular – paid high premiums for skimpy coverage.

Women who already had health insurance have a lot to gain by purchasing their coverage through the new Marketplaces. The individual market has long discriminated against women by charging them higher premiums just because they’re women and excluding coverage of important services like maternity care. Now, women no longer have to worry that they will be denied coverage because of a pre-existing condition or dropped from coverage when they get sick. They will know that their coverage won’t run out when they need it most and they won’t have to worry that burdensome out-of-pocket expenses will prevent them from receiving the care they need. Read more »

The Coverage Gap Poses Risks to Low Income Women's Health

Did you know that in the last 12 months nearly 60 percent of low-income uninsured women went without needed care because of cost? Or that in 2012 only 46 percent of low-income uninsured women received their recommended mammograms? What if we told you that states could take action to solve this problem today? And the federal government would start out paying for the full cost of this policy, and ultimately cover 90 percent of the bill?

You might be surprised, but this option is immediately available to all states. Under the Affordable Care Act (ACA), states may expand coverage through their Medicaid programs, providing health insurance to millions of low-income Americans. Yet twenty-five states have not done this, leaving over three million women in a coverage gap. This gap results from states’ failure to expand coverage and applies to individuals with incomes below the poverty level (approximately $11,500 for an individual) who do not qualify for traditional Medicaid. Women with income above poverty are eligible for subsidies for private health insurance available through their state Marketplace.

A new report from the National Women’s Law Center illustrates the risk the coverage gap poses to low-income women’s health. More specifically, the report shows that women in the coverage gap also experience a health care gap. In general, low-income women without health insurance are significantly less likely to access basic health care services on a regular basis and are less likely to use important preventive services than women who have similarly low incomes but who are covered by public or private health insurance. Read more »

Emergency! Emergency! But does the Oregon Medicaid study really tell us much about emergency department use under Obamacare?

Critics have pointed to this week’s study of emergency department use in the Oregon Medicaid program as the latest evidence of the ultimate – if not imminent – failure of health reform. In this examination of Oregonians who won the state’s 2008 health insurance lottery, and were thus able to enroll in Medicaid coverage, researchers from the National Bureau of Economic Research determined that newly-insured individuals used emergency departments 40 percent more often than similar, but uninsured, state residents. This conclusion, Obamacare critics allege, undermines a key argument for health reform, particularly for states that have not yet implemented expanded coverage under Medicaid – namely, that improving health coverage will reduce emergency department visits and, in turn, save money.

But not so fast. Leaving aside the absurdity of needing to participate in a lottery to get health coverage – a dehumanizing process that health reform will hopefully banish forever – the Oregon experience represents only one look at emergency department use after a Medicaid eligibility expansion. And this study only looks at the first 18 months after the lottery, which translates to an average of 13 months of coverage. In Massachusetts, which implemented health reform in 2006, emergency department use first grew (or continued to grow consistent with previous trends, depending on which study you look at) and then declined between 5 to 8 percent – with a significant drop in ED visits for problems that could be treated in a doctor’s office. Researchers attribute this decline to the reform’s expansion of coverage. Read more »

Forward Progress on Accepting Federal Funds to Cover More People in Medicaid

Last night’s election results are in and it’s a game changer for women and families in Virginia. Governor-elect Terry McAuliffe made the state’s choice of whether or not to cover more people in the Medicaid program a central component of his platform and, last night, the effort to provide coverage for hard-working low-income Virginians just got a burst of momentum with a champion headed to the Governor’s office.

The Medicaid eligibility expansion is a crucial part of the Affordable Care Act (ACA)—and is a main component of the ACA’s strategy for achieving near-universal health coverage. States may accept federal funding to expand coverage through Medicaid to all qualified individuals under age 65 who have incomes below 138 percent of the federal poverty line (FPL), or about $32,500 for a family of four. Approximately 15 million uninsured Americans, including 7 million women, will be newly eligible for health coverage through Medicaid. Read more »

News Reports Miss the Real Story on the Affordable Care Act’s Medicaid Enrollment

CBS and other news outlets have reported on the fact that many Americans are signing up for Medicaid coverage as part of the Affordable Care Act (ACA). Some of these reports suggest that this is somehow a crisis or a major problem with the law, but in fact, this is how Congress designed the ACA. The ACA extends health coverage to up to 30 million currently uninsured Americans through tax credits to purchase private insurance on the newly launched Health Insurance Marketplaces and through a major expansion of Medicaid eligibility. The Medicaid eligibility expansion is a crucial part of the health care law—and is a main component of the ACA’s strategy for achieving near-universal health coverage. States may accept federal funding to expand coverage through Medicaid to all qualified individuals under age 65 who have incomes below 138 percent of the federal poverty line (FPL), or about $32,500 for a family of four. Approximately 15 million uninsured Americans, including 7 million women, will be newly eligible for health coverage through Medicaid.

Here are a few facts that put these reports into context:

  •  This is how the ACA is supposed to work. According to estimates by the Urban Institute and the Kaiser Family Foundation almost half (47%) of the uninsured population could be eligible for coverage through the ACA’s opportunity to expand Medicaid eligibility. This Medicaid eligibility expansion was always going to be a big part of the ACA’s coverage goals.

We Have a Decision: West Virginia Governor Will Accept Federal Money to Cover Hard-Working Women and Families

West Virginians scored a huge win today! WV Governor Earl Ray Tomblin decided to accept federal funds available under the health care law to cover more hardworking women and families through the Medicaid program. After months of activism by fantastic on-the-ground organizations like WVFREE and state advocates, Governor Tomblin made the right call.

Why this decision is so important? Today’s announcement means that:

  • Over 67,000 women in West Virginia could be eligible for coverage.
  • When combined with other reforms in the health care law, this coverage expansion could reduce uninsurance in West Virginia by over 67%.
  • It will bring in $721 million federal dollars, and could save West Virginians over $281 million in uncompensated care costs.

Why Medicaid Expansion is Good for West Virginia

Read more »

Most People Want States to Take Federal Money to Cover More Uninsured People through Medicaid

Cross-posted from the Daily Kos.

Across the country, states continue to debate and negotiate whether they will accept federal money to cover more uninsured people through Medicaid. But nearly two out of three people have already made up their minds that lawmakers should take this unprecedented opportunity to cover more people, according to a new survey sponsored by the National Women’s Law Center and Georgetown University’s Center for Children and Families.

The new health care law known as the Affordable Care Act (ACA) allocates money for each state to cover more uninsured people through Medicaid. It’s a great deal for states, since these federal dollars will cover 100% of costs in the first few years and will ultimately pay for 90% of the yearly costs of this coverage. But because last year’s Supreme Court decision made accepting these funds optional, in states that choose to turn down the money, some people will earn too little to qualify for tax credits to purchase coverage in the new health insurance marketplace, yet won’t be able to obtain coverage through Medicaid. In other words, these people will fall into a “coverage gap” and will get no help toward affording health coverage, while some people who make more money will still get help.

Read more »

Opposition to Obamacare Thawing, Maine Has a Chance to Cover More People

We continue to watch Governors and state legislators across the country as they make a crucial decision that will have an enormous impact on women and families.

Under the new federal health care law, women and families in Maine who are currently uninsured could get affordable health coverage starting next year. That’s because the law includes money to cover more people through Medicaid. Right now, Maine has an important decision to make—accept federal dollars that have been allocated to cover uninsured individuals through Medicaid or turn down the money and leave them uninsured. If Maine accepts the federal funds to cover more people, not only will it improve women’s health and dramatically reduce the number of uninsured, it will also ensure a smarter use of health care dollars.

A recently released study backs this up! Yesterday researchers from Maine Equal Justice Partners and the Maine Center for Economic Policy released a comprehensive study on this opportunity. Their findings show that accepting federal funds to expand health coverage means thousands of Mainers will receive affordable comprehensive health coverage, and the state will also benefit through a boost to the state economy. Read more »

Major Part of Obamacare Has a Chance in Virginia

It’s been an exciting few weeks for advocates who are urging Governors and state legislators to say yes! Last June, the Supreme Court upheld the health care law but let states choose whether or not to take the Affordable Care Act’s funding for covering more people through the Medicaid program. Ever since then, Virginia advocates have had their work cut out for them—making phone calls, knocking on doors, and educating anyone who will listen about the important benefits to the state of Virginia, hospitals and health systems, and to the women and families who will gain the most.

Last weekend, Virginia took a big step forward. The two-year state budget includes a compromise proposal that could lead to Virginia extending coverage to approximately 350,000 Virginians who currently lack health insurance. Under this proposal, a legislative committee will ultimately determine whether the expansion will move forward. Governor McDonnell is currently reviewing this legislation.

What’s at stake by covering more people?

  • Approximately 169,000 Virginian women would gain health insurance coverage
  • Combined with other reforms in the Affordable Care Act, it could reduce the percentage of uninsured women in Virginia from 17 % to 4 %
  • Accepting the money could save Virginia approximately $424 million in uncompensated care costs over the next ten years
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