Should the federal government expand Medicare?
On the other hand, the federal government solely runs Medicare, so expansion would need to happen nationwide. Therefore, there must be majority support for the expansion of Medicare, and the bill must pass for it to be possible.
What is a Medicare expansion?
Medicare expansion refers to broadening the benefits of the program, as the parts in which beneficiaries enroll through the government provide limited coverage. Throughout the years, extensions of the program have been uncommon, with one of the most notable instances being coverage of disabled individuals under 65.
Does the federal government pay for health insurance expansion?
Under the ACA, the federal government paid 100 percent of the cost of expansion coverage from 2014 to 2016. The federal share then dropped gradually and settled at 90 percent for 2020 and each year thereafter, leaving the states to cover the small remaining share.
How many Americans have gained coverage through the ACA’s Medicaid expansion?
Nearly 10 million Americans have gained coverage through the ACA’s Medicaid expansion. The uninsured rate, particularly among low-income residents, is considerably lower in Medicaid expansion states. A provision in the Affordable Care Act (ACA) called for expansion of Medicaid eligibility in order to cover more low-income Americans.
What percentage of Medicare is paid by federal government?
As a whole, only 53 percent of Medicare's costs were financed through payroll taxes, premiums, and other receipts in 2020. Payments from the federal government's general fund made up the difference.
How much of the federal budget goes to Medicare?
Historical NHE, 2020: NHE grew 9.7% to $4.1 trillion in 2020, or $12,530 per person, and accounted for 19.7% of Gross Domestic Product (GDP). Medicare spending grew 3.5% to $829.5 billion in 2020, or 20 percent of total NHE.
How much does the federal government spend on Obamacare?
The CBO originally estimated that Obamacare would cost $940 billion over ten years. That cost has now been increased to $1.683 trillion.
Is the Affordable Care Act federally funded?
Under the ACA, the federal government pays 100 percent of the coverage costs for those newly insured under Medicaid expansion.
What percentage of healthcare is paid by the government?
Government Now Pays For Nearly 50 Percent Of Health Care Spending, An Increase Driven By Baby Boomers Shifting Into Medicare. A new CMS report projects that U.S. health care spending will surpass $5.9 trillion in 2027, growing to represent more than 19 percent of the economy.
What percentage of the federal budget goes to social programs?
In 2019, major entitlement programs—Social Security, Medicare, Medicaid, Obamacare, and other health care programs—consumed 51 percent of all federal spending, larger than the portion of spending for other national priorities (such as national defense) combined.
How much did Obamacare raise taxes?
Excise taxes on the health care industry raised $12 billion in 2019. An additional 0.9 percent Medicare tax on earnings and a 3.8 percent tax on net in-vestment income (NII) for individuals with incomes exceeding $200,000 and couples with incomes exceeding $250,000.
Did Obamacare save money?
First, the good news: We estimate that the ACA saved more than one-half trillion dollars.
Which program has the highest expenditure per enrollee in the US?
MedicareYou have no right to use this feature....Health spending per enrollee in the United States in 2018 and 2019, by insurance.Characteristic20182019Medicare12,76713,276Medicaid8,1238,4852 more rows•Sep 8, 2021
How does federalism affect the Affordable Care Act?
Medicaid's federal-state matching system of financing is the nation's largest example of fiscal federalism. Using generous federal subsidies, the Affordable Care Act incentivized states to expand Medicaid, which became a state option in the aftermath of a 2012 Supreme Court ruling.
Where does the money to fund the ACA come from?
To help offset the cost of the law, the ACA contains a revenue-raising provision that would place an excise tax on high-cost insurance plans, beginning in 2018. Most Americans receive health insurance through their employer and the cost of employer-sponsored health insurance is currently excluded from taxation.
Who benefits from the Affordable Care Act?
Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level (FPL). Expand the Medicaid program to cover all adults with income below 138% of the FPL.
What is Medicaid expansion?
A provision in the Affordable Care Act (ACA) called for the expansion of Medicaid eligibility in order to cover more low-income Americans. Under th...
Why are there some states that haven't implemented Medicaid expansion?
The ACA called for Medicaid expansion nationwide. But in June 2012, the Supreme Court ruled that states could not be forced to expand their Medicai...
How is Medicaid expansion funded?
The federal government is financing most of the cost of expanding Medicaid, and a small portion is being paid by participating states. The costs fo...
How many people are enrolled in coverage due to Medicaid expansion?
As of 2019, there were about 10 million people who had become newly eligible for Medicaid due to the ACA's expanded eligibility guidelines. But the...
What is the Medicaid coverage gap?
In the states that have not expanded Medicaid, there's a coverage gap that leaves about 2.2 million people ineligible for any sort of affordable co...
Which states have expanded Medicaid?
As of 2022, Medicaid has been expanded in 38 states and DC (you can click on a state on this map for more information about each state):AlaskaArizo...
Which states have refused to expand Medicaid?
As of 2022, the following states have not yet accepted federal funding to expand Medicaid:AlabamaFloridaGeorgiaKansasMississippiNorth CarolinaSouth...
What would happen if Medicare was expanded?
This proposed Medicare expansion, based on Medicare rates and taxpayer subsidies, would further erode private health coverage—and create a new class of persons dependent on government. It would make federal taxpayers pay for private businesses’ heath care bills.
What is the expansion of government health care financing?
The expansion of government health care financing is the expansion of government power and control over Americans’ health care. That, finally, is the point of the Biden ...
What is the age limit for Medicare?
President Joe Biden is committed to expanding the Medicare program by reducing the normal age of entitlement eligibility from 65 to 60. According to his fiscal year (FY) 2022 budget submission to Congress, the President wishes to provide Americans in the 60 to 64 age group “the option to enroll in the Medicare program with ...
How many people will be eligible for Medicare at age 60?
According to Avalere, a prominent Washington, DC–based health policy research firm, opening the Medicare program to persons between the ages of 60 and 64 could shift an estimated 24.5 million persons from existing health insurance coverage into the Medicare program. 4.
What should lawmakers focus on in Medicare reform?
Lawmakers should focus on reforms that improve Medicare, including the Health Insurance Trust Fund, so that the program is solvent and available in the future.
How does Biden's proposal affect private health insurance?
By crowding out private coverage options, the Biden proposal would, over time, further consolidate the nation’s health insurance coverage under direct federal control, thus further weakening competition in the already severely damaged health insurance markets , as well as further eroding personal choice of coverage and alternatives to medical care.
How many people are on Medicare?
Medicare, serving 61.2 million beneficiaries, is the nation’s largest payer for health care benefits and services. Beneficiaries’ premiums cover only 15 percent of the program’s total cost; taxpayers cover the rest. 12
What is Medicare expansion?
Medicare expansion refers to broadening the benefits of the program, as the parts in which beneficiaries enroll through the government provide limited coverage. Throughout the years, extensions of the program have been uncommon, with one of the most notable instances being coverage of disabled individuals under 65.
What would happen if Medicare expansion went through?
If the proposed Medicare expansion goes through, Americans would see both pros and cons. Clearly, the most positive effect would be beneficiaries receiving additional health care at no extra cost to them. On the other hand, there would still be major gaps in Medicare coverage that cause larger financial burdens for seniors and their families, as well as a greater need for taxpayer funding of the program.
What is a Medigap plan?
Additionally, Medigap plans are another type of supplemental insurance. These plans cover the coinsurance costs that come with Original Medicare.
How does Medicare get its funding?
Medicare primarily receives funding through payroll taxes. Thus, more tax revenue will be necessary for an expansion to be possible.
Does Medicare cover everything?
In reality, Medicare coverage doesn’t include everything. Still, politicians have their eye on Medicare expansion to close the gap between the federal program’s current offerings and the complete coverage seniors want and need.
Is Medicaid the same as Medicare?
While many states have expanded their Medicaid programs, the process for doing the same with Medicare would be very different. Medicaid is government health insurance for those with low incomes, which the federal and state governments collectively manage.
Can states expand Medicaid?
No state has the power to expand Medicare, as it is a federal program. However, states are able to expand their Medicaid programs within federal guidelines.
Which states have Medicaid expansion?
Five states — Texas, North Carolina, Florida, Georgia, and Tennessee — account for the lion’s share of the coverage gap population, and they are among the 14 states where expansion is still a contentious issue and the legislature and/or governor are still strongly opposed to accepting federal funding to expand Medicaid.
How many states have expanded Medicaid?
Thirty-six states and DC have either already expanded Medicaid under the ACA or are in the process of doing so. Fourteen states continue to refuse to adopt Medicaid expansion, despite the fact that the federal government will always pay 90% of the cost.
How many people will be eligible for medicaid in 2021?
But the COVID pandemic drove the enrollment numbers significantly higher: As of 2021, there were about 14.8 million Medicaid enrollees who had gained eligibility due to Medicaid expansion, plus another 4 million who were already eligible for Medicaid under pre-ACA rules, but who had enrolled due to outreach and enrollment assistance efforts since the ACA was implemented.
What is the ACA expansion?
A provision in the Affordable Care Act ( ACA) called for expansion of Medicaid eligibility in order to cover more low-income Americans. Under the expansion, Medicaid eligibility would be extended to adults up to age 64 with incomes up to 138 percent of the federal poverty level (133 percent plus a 5 percent income disregard).
How many states will have Medicaid in 2021?
As of 2021, Medicaid has been expanded in 38 states and DC (you can click on a state on this map for more information about each state):
How much has Medicaid increased since 2013?
Total enrollment in Medicaid/CHIP has increased by 42% since 2013, and that includes the dozen states that continue to reject federal funding to expand Medicaid.
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The mission of healthinsurance.org and its editorial team is to provide information and resources that help American consumers make informed choices about buying and keeping health coverage. We are nationally recognized experts on the Affordable Care Act (ACA) and state health insurance exchanges/marketplaces. Learn more about us.
How many states have expanded Medicaid?
To some liberal Democrats, the plan seems unfair to the 38 states that have expanded Medicaid under the original terms of the health law — at a higher cost to those states.
Which states have refused to expand Medicaid?
But in raw political terms, most of the states that have refused to expand Medicaid — like Alabama, Mississippi, South Carolina, South Dakota, Tennessee and Wyoming — are out of reach for Democrats. Older Americans, on the other hand, are consistent voters, increasingly up for grabs. Those voters would like Medicare to start paying for dental, vision and hearing care.
Why don't people in Florida have health insurance?
Representative Charlie Crist, a Florida Democrat who was once his state’s Republican governor, noted that 800,000 of its residents do not have health insurance because the state leadership refuses to expand Medicaid. But Florida also has a significant older population that wants expanded coverage under Medicare.
Should Congress reward states that refused to expand Medicaid?
Some Democrats, moreover, say Congress should not reward states that refused to expand Medicaid by creating a separate insurance program, financed entirely by the federal government, for their working poor. Under the Affordable Care Act, states that expand Medicaid pay 10 percent of the cost. The topic came up during a recent policy luncheon for Senate Democrats.
Does Texas have expanded Medicaid?
Caught between those competing imperatives are lawmakers like Representative Lloyd Doggett, a senior Democrat on the Ways and Means Committee whose home state, Texas, has not expanded Medicaid. In a fight for scarce resources, he said, seniors who already have good coverage for most of their health needs under Medicare must take a back seat to the working poor who have no coverage at all.
Do Republicans support expanding Medicare?
Republicans are largely absent from the conversation; they oppose the budget measure in its entirety, and thus are not weighing in on whether to expand Medicare or Medicaid. But they have long been opposed to letting Medicare negotiate drug prices, which they argue would stifle innovation in the pharmaceutical industry.
Will the Affordable Care Act extend to the poor?
Two House committees — Ways and Means and Energy and Commerce — adopted a measure last week that for now would extend existing premium subsidies under the Affordable Care Act to those now too poor to qualify for them , covering 94 percent of their total health care costs, rising to 99 percent in 2023. By 2024, the Department of Health and Human Services will have stood up a Medicaid-like program along the lines of the Senate proposal for those 4.4 million people.
How much of the Medicaid expansion will be paid?
States will never be responsible for more than 10 percent of the cost of Medicaid expansion. The federal government paid the full cost of expansion from 2014 through 2016. The federal government's portion gradually dropped to 90 percent by 2020, and will stay there permanently.
How many states are expanding Medicaid?
36 states and the District of Columbia have expanded Medicaid as of early 2021, and two more — Oklahoma and Missouri — will expand Medicaid in mid-2021.
Why is Medicaid expansion important?
There are a few reasons for that: Medicaid expansion allows some states to shift certain populations from traditional Medicaid eligibility to the Medicaid expansion category, where the federal government pays a much larger portion of the cost.
When did the federal government pay for the expansion?
The federal government paid the full cost of expansion from 2014 through 2016. The federal government's portion gradually dropped to 90 percent by 2020, and will stay there permanently. Q.
Does Medicaid cover mental health?
Medicaid expansion reduces the need for state spending on uncompensated care and mental health/substance abuse treatment for low-income residents, since fewer low-income people in the state are uninsured. It also allows states to use the Medicaid program to cover the cost of inpatient medical care for incarcerated people.
How many states have Medicaid expansion?
Of the 32 states that, along with the District of Columbia, have implemented Medicaid expansion, nine are using taxes — on cigarettes; alcohol; or hospital, provider, or health plan fees — to help pay for it.
Which states have expanded Medicaid?
In November, voters in Idaho, Nebraska, and Utah overwhelmingly approved state ballot initiatives to expand Medicaid. And in January, new governors supportive of expansion took office in Kansas and Wisconsin. The prospect of Medicaid expansion in these five states plus Maine, where implementation is finally under way following a 2017 ballot ...
What percentage of Medicaid will be paid in 2020?
In 2020, the federal share will drop to 90 percent where, barring a change to the law, it will stay. This leaves states on the hook for at most 10 percent of the total cost of enrollees in the new eligibility category — considerably less than the roughly 25 percent to 50 percent of the cost that states pay for enrollees eligible for Medicaid ...
Why is Medicaid expansion important?
That’s because expansion allows states to realize savings by moving adults who are in existing state-funded health programs into expansion coverage. Expansion also allows states to reduce their spending on uncompensated care as uninsured people gain coverage.
Does Medicaid expand the economy?
States that expand Medicaid also realize economic benefits beyond increased federal funds. For example, a Commonwealth Fund-supported study found that as a result of new economic activity associated with Medicaid expansion in Michigan, including the creation of 30,000 new jobs mostly outside the health sector, state tax revenues are projected to increase $148 million to $153 million a year from FY2019 through FY2021.
Did Medicaid expansion increase state spending?
Indeed, a national study confirmed that during the two years when the federal government paid all of the costs for newly eligible enrollees, Medicaid expansion did not lead to any significant increases in state spending on Medicaid or to reductions in spending on other priorities such as education.
Who is the senator that backed expansion?
A U.S. Senate bill cosponsored by Senator Doug Jones (D–Ala.), who has advocated for his state to adopt expansion, could help reassure states skittish about expanding because of the impact on their budget.
What is the expansion of medicaid?
Medicaid expansion drives gains in health coverage among people who were previously eligible for Medicaid, including children and parents. Most children in families with low incomes were eligible for Medicaid before the ACA, but Medicaid eligibility for parents was limited and varied considerably across states.
How has expansion of Medicaid helped?
States also spent less on programs for people with mental health or behavioral health needs since Medicaid paid for their treatment, and less on corrections as federal Medicaid dollars paid more of the inpatient hospital costs of inmates who were eligible for and enrolled in Medicaid. And, in states that tax managed care plans and health care providers serving Medicaid beneficiaries, higher enrollment generated revenue gains that further offset expansion’s costs. Taken together, these factors are why state and independent analyses, including in states such as Arkansas, Kentucky, Louisiana, Michigan, Montana, and Virginia, have consistently showed expansion produced net savings for many states. [1] In fact, expansion is associated with a more than 4 percent reduction in states’ spending on their traditional Medicaid programs. [2]
How many people were covered by medicaid before the recession?
Before COVID-19 and the recession, over 12 million people had health coverage through the Medicaid expansion. Another 4 million uninsured people would become eligible for it if all 12 states that have not enacted Medicaid expansion did so, including 2.2 million who fall in the “coverage gap” — those whose incomes are too low to qualify for subsidized marketplace coverage, but who also do not qualify for their states’ Medicaid programs. [5] In non-expansion states, the median income limit for parents to qualify for Medicaid is about 40 percent of the poverty line, and childless adults do not qualify at all. [6] Of those in the coverage gap, 60 percent are people of color and virtually all live in the South. [7] (See Figure 2.)
Why is Medicaid expansion important?
Improved health outcomes. Medicaid expansion is linked to earlier detection, diagnosis, and treatment of serious medical conditions, such as a reduction in the number of uninsured patients with breast cancer and a decrease in late-stage breast cancer detection . [13] Patients with end-stage renal disease who live in a Medicaid expansion state have lower one-year mortality rates than those in non-expansion states, and Black patients have experienced the greatest decline in mortality rates. [14]
How does Medicaid expansion affect maternal health?
Decrease in maternal and infant mortality rates. Medicaid expansion improves access to health care before, during, and after pregnancy, thereby improving maternal and infant health. [17] Medicaid expansion has helped reduce maternal mortality, preventing over 200 deaths in 2017 alone. [18] Infant mortality fell in both expansion and non-expansion states between 2010 and 2016, but it fell 50 percent more in expansion states and disparities in infant mortality rates along racial lines fell in those states as well. [19] Medicaid expansion also has driven more preconception health counseling and more use of the most effective birth control measures after childbirth. [20]
How does Medicaid expansion help?
Medicaid expansion makes people healthier and more financially secure by improving access to preventive and primary care, providing care for serious diseases, preventing premature deaths, and reducing the cases of catastrophic out-of-pocket medical costs, a large body of research shows. [9] .
What states did Trump take away Medicaid?
The Trump Administration encouraged states to adopt policies taking Medicaid coverage away from people who did not meet work requirements. In Arkansas, the one state to implement work requirements, 18,000 Medicaid enrollees — nearly 1 in 4 adults subject to the requirements — lost their coverage. In New Hampshire, about 40 percent of adults subject to work requirements would have lost their coverage if the state had not put the policy on hold. The Biden Administration subsequently withdrew Arkansas’ and New Hampshire ’s authority to continue their work requirements programs.
What percentage of income is eligible for Marketplace Plan?
If your expected yearly income increases so it’s between 100% and 400% of the federal poverty level (FPL), you become eligible for a Marketplace plan with advance payments of the premium tax credit (APTC). If your income increases to above 400% FPL, you may still qualify for savings.
What is the poverty level for Medicaid?
When the health care law was passed, it required states to provide Medicaid coverage for all adults 18 to 65 with incomes up to 133% (effectively 138%) of the federal poverty level, regardless of their age, family status, or health. The law also provides premium tax credits for people with incomes between 100% and 400% of ...
Is Medicaid expansion voluntary?
The U.S. Supreme Court later ruled that the Medicaid expansion is voluntary with states. As a result, some states haven’t expanded their Medicaid programs. Adults in those states with incomes below 100% of the federal poverty level, and who don’t qualify for Medicaid based on disability, age, or other factors, fall into a gap.
Do you have to pay for low cost medical care?
See how to get low-cost care in your community. If you don’t have any coverage, you don’t have to pay the fee. For plan years through 2018, most people must have health coverage or pay a fee. But you won’t have to pay this fee if you live in a state that hasn’t expanded Medicaid and you would have qualified if it had.
How much has Medicaid increased in recent years?
Growth in total Medicaid spending has slowed in recent years, increasing by approximately 3 percent per year since 2017, compared to 5 percent in 2016 and 11 percent in 2015 ( CMS 2020a, CMS 2020b, CMS 2019 ). Per enrollee benefit spending is estimated to have increased by 3.6 percent between 2016 and 2017. Growth in per enrollee benefit spending is projected to have slowed in 2018 to 0.9 percent ( CMS 2020 ). For more on enrollment changes, see Medicaid enrollment changes following the ACA. It is still unclear how these trends have changed since the onset of the COVID-19 pandemic.
How much is Medicaid spending?
In fiscal year (FY) 2018, total Medicaid spending was estimated at $616.1 billion, with spending on the newly eligible adults ( CMS 2020 ). [1]
What was the impact of Medicaid in 2014?
In 2014, high Medicaid spending growth rates nationally reflected the combined effects of increased enrollment as well as increased spending per enrollee. Along with new high-cost drugs and a required increase in primary care payments, expanded coverage for adults was a key driver of spending growth rates. However, spending growth rates were lower for 2015–2017 and are projected to be even lower for 2018 ( CMS 2020 ). This is due, in part, to the initial 2014 surge in enrollment continuing to diminish ( Keehan et al. 2016 ).
What percentage of Medicaid is federal?
Historically, the federal share of Medicaid has averaged about 57 percent ; however, under the ACA, the matching rate is higher for adults newly covered under the program. The federal government paid 100 percent of state Medicaid costs for certain newly eligible individuals through the end of 2016. Starting in 2017, the matching rate declined slightly each year until it reached 90 percent in 2020, and will remain there (see table below).
Is Medicaid expansion good for the state budget?
Although the share of Medicaid spending borne by states has increased as states take on a larger share of the costs for the newly eligible, there is some evidence to indicate that Medicaid expansion has been beneficial for state budgets.
Who is eligible for 100 percent matching?
Individuals eligible to receive the 100 percent matching rate included those who would not have been eligible for Medicaid in the state as of December 1, 2009, or who were eligible under a waiver but not enrolled because of limits or caps on waiver enrollment. As of June 2019, there were 14.8 million enrollees in the new group in ...
Is enrollment slowing in 2019?
States have reported that spending and enrollment growth continued to slow in 2018 and 2019. A strong economy, resumption of redeterminations in states that had previously delayed them due to eligibility system upgrades, and improved data matching capabilities, contributed to enrollment declines in FY 2019 ( MACPAC 2019 ).
Drawbacks
Impact on Medicare
Who Would Be Impacted?
Increasing Incentives to Drop Employer Coverage
Social Policy in Search of A Problem
Worsening Medicare’s Financial Condition
- Medicare, serving 61.2 million beneficiaries, is the nation’s largest payer for health care benefits and services. Beneficiaries’ premiums cover only 15 percent of the program’s total cost; taxpayers cover the rest.12Davis, “Medicare Financial Status.” Based on Biden’s budget submission for FY 2022, compared to last year’s spending of $884 billion...
Other Potential Consequences
Conclusion