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Medicaid expansion under ACA is seen as permanent

 

This CNBC article and video suggests that Medicaid expansion under the Affordable Care Act has so many constituents now that it will  be very difficult to reverse, even in  states that are now run by Republicans.

As the article notes the new patients now covered by Medicaid expansion generally like it. And so do hospitals, which now don’t have to  cover so much uncompensated care

As CNBC notes: “A growing number of states have signed up for that expansion of the government-run program for poor people, or are discussing doing so. Hospitals are becoming accustomed to the money that comes with expansion, and a majority of new enrollees are saying they are happy with their coverage.

“The difficulty of getting rid of Medicaid expansion, which uses federal dollars to give health benefits to previously ineligible adults, was sharply underscored this fall by the election of ardent Obamacare foe Matt Bevin as governor of Kentucky.

“The Republican Bevin originally promised to repeal expansion of Medicaid in Kentucky, where about 400,000 have joined the Medicaid rolls since the Affordable Care Act was implemented. He since has backed away from that vow. Bevin most recently has talked about redesigning the state’s Medicaid program, but has not yet offered a plan.”

“I do think we’ve reached the tipping point,”  Diane Rowland, executive vice president of the Kaiser Family Foundation, told CNBC.  “It’s part of the fabric of our health-care system now.”

“I think there are still states that are strongly resistant to it, but I think the tide is beginning to sweep more states in,” she added.

 


Indiana plan as a template for Ky. Medicaid?

govoffice

The Kentucky governor’s office. (Photo by Erin Pettigrew).

Kentucky’s new Republican governor, Matt Bevin, who has denounced the Affordable Care Act, wants to revise the state Medicaid program, which was expanded under the ACA with a federal waiver like  the one that Indiana uses.

Instead of the traditional 1115 Medicaid waiver, Bevin’s administration reportedly will seek a 1332 waiver, part of the ACA that lets states organize heir own healthcare programs as long as the number of covered people remains the same or greater.

But states can’t  apply for a 1332 waiver until Jan. 1, 2017.

Assuming that Kentucky uses the Indiana  template for Kentucky’s revised Medicaid expansion, low-income residents will pay for more of their medical costs, which probably would discourage  many  of them from enrolling.

 


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