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Justin Puckett

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Watch for unintended effects of Medicaid-expansion phaseout

Justin Puckett and Jalpa Doshi write in Health Affairs “that if Congress eventually revives its plan to phase out the Medicaid expansion, many marketplace enrollees with preexisting conditions will find their protections eroded and coverage rendered worthless.”

“Although ideological opposition to the Medicaid expansion makes its future uncertain, policymakers should be cognizant of the unintended consequences of modifying the expansion. They should also be aware that insurers may expand their use of adverse tiering in order to circumvent protections for individuals with preexisting conditions, leaving sicker, low-income patients with ineffectual coverage and no viable alternative. Any serious replacement proposal that seeks to maintain protections for these patients while rolling back the Medicaid expansion must grapple with the fact that guaranteed issue does not always mean guaranteed access.”

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Wellesley, Mass