Why should we expand health insurance coverage for uninsured adults?
Context: Uninsured adults have less access to recommended care, receive poorer quality of care, and experience worse health outcomes than insured adults do. The potential health benefits of expanding insurance coverage for these adults may provide a strong rationale for reform.
What happens when the number of uninsured individuals increase?
Such a large increase in the number of uninsured individuals would reverse the gains in access, utilization, and affordability of care and in addressing disparities achieved since the law was implemented.
How can the government decrease the cost of Medicare?
The government could decrease Medicare costs if they adjusted the criteria for bonuses, and increased overall competition between plans. 15 Decrease Medicare fraud, waste, and abuse: Private insurance companies run Medicare Advantage (Part C) and prescription drug plans (Part D).
What does the ACA Medicaid expansion mean for You?
The ACA Medicaid expansion was designed to address historically high uninsured rates among low-income adults, providing a coverage option for people with limited access to employer coverage and limited income to purchase coverage on their own.
What are the cons of Medicaid expansion?
List of Medicaid Expansion ConsFree health insurance is usually available to those who need it. ... It could create delays when trying to visit a doctor. ... Doctors are not required to accept patients on Medicaid. ... It only benefits specific segments of the population. ... Expansion would stop the benefits of private insurance.More items...•
What is the effect of Medicaid expansion under the ACA?
As a whole, the large body of research on the effects of Medicaid expansion under the ACA suggests that expansion has had largely positive impacts on coverage; access to care, utilization, and affordability; and economic outcomes, including impacts on state budgets, uncompensated care costs for hospitals and clinics, ...
What were the three 3 positive effects associated with expanding Medicaid coverage when compared to states which did not expand Medicaid?
Access to care and related measures: Most research demonstrates that Medicaid expansion has improved access to care, utilization of services, the affordability of care, and financial security among the low-income population.
What is the highest income to qualify for Medicaid?
Federal Poverty Level thresholds to qualify for Medicaid The Federal Poverty Level is determined by the size of a family for the lower 48 states and the District of Columbia. For example, in 2022 it is $13,590 for a single adult person, $27,750 for a family of four and $46,630 for a family of eight.
What are the cons of the Affordable Care Act?
Cons:The cost has not decreased for everyone. Those who do not qualify for subsidies may find marketplace health insurance plans unaffordable. ... Loss of company-sponsored health plans. ... Tax penalties. ... Shrinking networks. ... Shopping for coverage can be complicated.
What are the negative impacts of the ACA?
The ACA has been highly controversial, despite the positive outcomes. Conservatives objected to the tax increases and higher insurance premiums needed to pay for Obamacare. Some people in the healthcare industry are critical of the additional workload and costs placed on medical providers.
Was Obama care a good thing?
The Affordable Care Act has both increased the number of insured Americans and improved the coverage offered by health insurance companies. Millions of previously uninsured Americans have been able to obtain health insurance because of the ACA.
Does Medicaid decrease or increase health care disparities?
Overall, research shows that Medicaid expansion is associated with reductions in racial/ethnic disparities in health coverage as well as narrowed disparities in health outcomes for Black and Hispanic individuals, particularly for measures of maternal and infant health.
Why the Affordable Care Act is good?
The ACA supports public health prevention efforts. It created the Prevention and Public Health Fund, which has paid for public health efforts across the country. The ACA requires insurance policies to cover essential health benefits that can help prevent serious, costly conditions.
How can I hide money from Medicaid?
5 Ways To Protect Your Money from MedicaidAsset protection trust. Asset protection trusts are set up to protect your wealth. ... Income trusts. When you apply for Medicaid, there is a strict limit on your income. ... Promissory notes and private annuities. ... Caregiver Agreement. ... Spousal transfers.
Which state has highest income limit for Medicaid?
AlaskaThe state with the highest income limits for both a family of three and individuals is Washington, D.C. If you live in this area, a family of three can qualify for Medicaid if their income is at 221% of the FPL....Medicaid Income Limits by State 2022.StateAlaskaParents (Family of 3)138.00%Other Adults138.00%2022 Pop.720,76349 more columns
How do I qualify for dual Medicare and Medicaid?
Persons who are eligible for both Medicare and Medicaid are called “dual eligibles”, or sometimes, Medicare-Medicaid enrollees. To be considered dually eligible, persons must be enrolled in Medicare Part A (hospital insurance), and / or Medicare Part B (medical insurance).
Medicare Advantage Plan (Part C)
Monthly premiums vary based on which plan you join. The amount can change each year.
Medicare Supplement Insurance (Medigap)
Monthly premiums vary based on which policy you buy, where you live, and other factors. The amount can change each year.
How much does uninsurance decrease?
Overall, the research found that a 10-percentage-point decrease in uninsurance would be associated with a roughly 8-percent decrease in the volume of visits billed to workers' compensation. This implies that, at least for the group studied, health insurance and workers' compensation coverage are substitutable for some.
What would happen if health insurance access increased?
If health insurance access increased, workers compensation costs might drop. On the other hand, doctors and hospitals might seek to bill care to workers' compensation when it provides more generous reimbursement than other payers, such as private insurance.
How did the ACA affect people under 26?
The ACA expanded coverage for people under the age of 26 by making them eligible to stay on their parents' employers' health insurance. That created a sample that the researchers could compare against people just over the age of 26 to explore how health insurance coverage affected use of workers' compensation.
Does workers compensation cover on the job injuries?
Despite the volume of care provided under workers' compensation, little is known about how the availability of health insurance affects the frequency and cost of workers' compensation claims. For example, although workers' compensation plans are required to cover on-the-job injuries and illnesses, workers may prefer to avoid ...
Does expansion of health care coverage affect the total number of emergency hospitalizations for this under-30 population?
The expansion of health care coverage did not affect the total number of emergency hospitalizations for this under-30 population. That finding increases confidence that the results are not likely to reflect bias in selection of which young adults visit the emergency room.
Does expansion of health insurance increase workers compensation?
Theoretically, expansion of health insurance access could either lower or raise workers' compensation costs. For instance, people without health insurance who were injured off the job sometimes claim to have been injured at work to receive subsidized care and coverage. If health insurance access increased, workers compensation costs might drop.
Does the ACA cover young people?
Wider health insurance coverage for young Americans under the Affordable Care Act (ACA) reduces their reliance on state workers' compensation programs when they require emergency care, according to RAND research. The RAND analysis of younger workers, which examined millions of medical records in four populous states, ...
What is the ACA expansion?
The ACA Medicaid expansion was designed to address historically high uninsured rates among low-income adults, providing a coverage option for people with limited access to employer coverage and limited income to purchase coverage on their own. In states that expanded Medicaid, millions of people gained coverage, ...
How many people would be eligible for Medicaid if they were not expanding?
If states that are currently not expanding their programs adopt the Medicaid expansion, all of the nearly 2.2 million adults in the coverage gap would gain Medicaid eligibility. In addition, 1.8 million uninsured adults with incomes between 100 and 138% of poverty 6 (most of whom are currently eligible for Marketplace coverage) ...
What percentage of people in the Medicaid coverage gap are adults without dependent children?
Reflecting limits on Medicaid eligibility outside ACA pathways, most people in the coverage gap (77%) are adults without dependent children. 4. Adults left in the coverage gap are spread across the states not expanding their Medicaid programs but are concentrated in states with the largest uninsured populations.
What is the gap in Medicaid coverage?
The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid. The economic downturn and change in Administration are likely to bring renewed attention to gaps in Medicaid coverage in states that have not expanded eligibility under the Affordable Care Act (ACA). In recent months, millions have gained health insurance coverage ...
Why are there no uninsured adults in Wisconsin?
There are no uninsured adults in the coverage gap in Wisconsin because the state is providing Medicaid eligibility to adults up to the poverty level under a Medicaid waiver. The geographic distribution of the population in the coverage gap reflects both population distribution and regional variation in state take-up of the ACA Medicaid expansion.
Why do people fall into the Medicaid coverage gap?
At a time when many need health care services due to the health care crisis or face loss of financial security due to the economic downturn, millions fall into the Medicaid coverage gap due to their state’s decision not to expand eligibility.
What is the uninsured rate in 2019?
In 2019 the uninsured rate in non-expansion states was nearly double that of expansion states (15.5% vs. 8.3%). By definition, people in the coverage gap have limited family income and live below the poverty level.
How much did Medicare Part B cost in 2017?
That happened in 2018, after two straight years of Medicare Part B premium hikes with almost no Social Security COLA. While the base rate for Part B was $134 a month in 2017, most enrollees paid less ($109, on average) to keep their Social Security benefits from decreasing.
What percentage of Medicare Part B is covered by Social Security?
When the “standard” rate for Medicare Part B (health insurance) rises, as it does most years, the roughly 70 percent of Part B enrollees protected by the rule get what amounts to a discount so that their Social Security payment doesn’t decrease.
Does Medicare Part B reduce Social Security?
When the “standard” rate for Medicare Part B (health insurance) rises, as it does most years, the roughly 70 percent of Part B enrollees protected by the rule get what amounts to a discount so that their Social Security payment doesn’t decrease. But … rising Medicare premiums can prevent your Social Security benefits from going up, ...
What is the impact of the drop in Medicaid coverage among Hispanics?
Drops in coverage among Hispanic people drove much of the increase in the overall uninsured rate in 2019. Changes to the Federal public charge policy may be contributing to declines in Medicaid coverage among Hispanic adults and children, leading to the growing number without health coverage.
Why are people uninsured in 2019?
In 2019, 73.7% of uninsured adults said that they were uninsured because the cost of coverage was too high. Many people do not have access to coverage through a job, and some people, particularly poor adults in states that did not expand Medicaid, remain ineligible for financial assistance for coverage.
How many states have uninsured people in 2019?
Changes in the number of uninsured individuals varied across states in 2019. A total of 13 states experienced increases in the number of nonelderly uninsured individuals, including nine Medicaid expansion states and four non-expansion states.
What is the uninsured rate in 2019?
The uninsured rate among children was 5.6% in 2019, less than half the rate among nonelderly adults (12.9%), largely due to broader availability of Medicaid and CHIP coverage for children than for adults (Figure 5). Figure 5: Uninsured Rates among the Nonelderly Population by Selected Characteristics, 2019.
How many uninsured Americans are there in 2019?
However, beginning in 2017, the number of uninsured nonelderly Americans increased for three straight years, growing by 2.2 million from 26.7 million in 2016 to 28.9 million in 2019, and the uninsured rate increased from 10.0% in 2016 to 10.9% in 2019.
What is the ACA?
The Affordable Care Act (ACA) sought to address the gaps in our health care system that leave millions of people without health insurance by extending Medicaid coverage to many low-income individuals and providing subsidies for Marketplace coverage for individuals below 400% of poverty.
What percentage of the uninsured are white?
While a plurality (41.1%) of the uninsured are non-Hispanic White people, in general, people of color are at higher risk of being uninsured than White people. People of color make up 43.1% of the nonelderly U.S. population but account for over half of the total nonelderly uninsured population (Figure 4).
A Natural Experiment
Lower Or Higher Costs?
- Theoretically, expansion of health insurance access could either lower or raise workers' compensation costs. For instance, people without health insurance who were injured off the job sometimes claim to have been injured at work to receive subsidized care and coverage. If health insurance access increased, workers compensation costs might drop. On the other hand, doctor…
Deep Data on Workers' Compensation
- The RAND researchers looked at data on more than 17 million hospital visits for young adults in four states: California, Florida, New Jersey, and New York. The date range for the data extended from 2005 through 2012, with some differences in time spans from state to state. Specifically, the researchers examined state emergency department data, which contain patient discharge recor…
Evidence of Fewer Workers' Compensation Billings
- The analysis showed a statistically significant reduction in workers' compensation billings for the younger group, who gained coverage under the ACA. The magnitude of the reduction was economically significant, with a 1-percent reduction in uninsurance equating to a 0.8-percent decrease in workers' compensation claim frequency — and a roughly 1-per...
Buttressing The Findings
- Additional lines of analysis bolstered the proposition that expansion of health insurance coverage led to fewer workers' compensation billings: 1. The expansion of health care coverage did not affect the total number of emergency hospitalizations for this under-30 population. That finding increases confidence that the results are not likely to reflect bias in selection of which young ad…
The Four States
- Among the states examined, the variety of health insurance requirements and workers' compensation programs provided multiple tests for the researchers' analytical model, along with varied results. The analysis found that in California, the probability thata particular emergency hospital visit was billed to workers' compensation fell by 0.143 of a percentage point among tho…
For Further Consideration
- The RAND research, which was based on the most comprehensive data and analysis applied to the issue to date, established the effects that expansion of dependent care provisions under the ACA have on workers' compensation billings. It also showed variations in that effect, depending on the types of injuries and the generosity of states' workers' compensation systems. Whether t…