The Importance of Medicaid

Medicaid is crucial in supporting low-income households in obtaining healthcare coverage and provides health insurance to nearly 60 million children and families. Since Medicaid has strict rules for eligibility, the expansion of Medicaid benefits those who had not been previously eligible for any type of affordable health coverage. Under the current eligibility requirements, state Medicaid programs must cover children under the age of 6 living in families with incomes below 133% of the federal poverty level and children ages 6-18 with family incomes below 100% of the FPL. However, states can decide whether or not to extend eligibility further. For example, states must cover children up to 18 years of age, but have the option to cover 19 and 20 year olds. In addition, states must provide coverage to pregnant women with family incomes below 133% of the FPL and parents with incomes below 50% of the FPL, but have the option to provide coverage to these groups above the minimums.

Adults who are not disabled, pregnant, or elderly, and have no minor children generally have been excluded from Medicaid.  In the past, to extend Medicaid to these adults, states had to receive a waiver and could not receive additional federal Medicaid funds for this coverage; instead, states needed to redirect existing federal Medicaid funds or create program savings to offset the cost of the coverage.  As a result, the expansion of Medicaid will cover an additional 22.3 million uninsured individuals with incomes below 138% of the FPL.

Medicaid is jointly funded by the federal government and states. To finance the expansion, the federal government will cover 100% of the states’ cost in covering newly eligible Medicaid recipients, then phase down its federal contribution to 95% between  2014 and 2019, then again to 90% in 2020. Since April 2010, California, Connecticut, Minnesota, New Jersey, Washington, and the District of Columbia have expanded Medicaid to low-income adults and have been able to cover an additional 600,000 people.  These states were able to preserve, expand, and strengthen coverage for their low-income residents.

 According to The Urban Institute, if a state does not implement the expansion, some individuals would receive federal tax credits and other subsidies instead of Medicaid; however, cost-sharing requirements would be higher. Federal tax credits and subsidies would not be available for most people with incomes below the federal poverty line, which means uninsured individuals living above poverty can receive help, but those living below poverty would not. Rejecting federal funds and refraining from the expansion could have adverse impacts on more than 27 million uninsured Americans with incomes below 138 percent of the poverty level.

For state policymakers, it is important to consider the economic and societal benefits of providing healthcare to those who currently lack access to affordable coverage and to reduce coverage disparities.  

For state policy strategies to ensure that children are healthy, visit PolicyforResults.org. 

April is National Minority Health Month

The U.S. Department of Health and Human Services is commemorating National Minority Health Month by encouraging Town Halls and hosting events throughout the month to raise awareness of the disparities that exist in health care. While the average quality of health care has risen over the past few decades, disparities to health care access and quality of care have not improved. In a press release, HHS highlights how the Affordable Care Act (ACA) has already improved health disparities by providing coverage to previously uninsured minorities and eliminating co-pays or deductibles for some essential preventative services.

During last year’s Minority Health Month, HHS announced its first initiative solely focused on resolving disparities to health care access. The HHS Action Plan to Reduce Racial and Ethnic Health Disparities builds on the Affordable Care Act and other existing strategies, such as Healthy People 2020, to reduce health disparities among minorities. The report outlines where and why health disparities exist and carries five policy goals to remove those disparities: Transform Health Care; Strengthen the Nation’s Health and Human Services Infrastructure and Workforce; Advance the Health, Safety, and Well-Being of the American People; Advance Scientific Knowledge and Innovation; and Increase Efficiency, Transparency, and Accountability of HHS Programs. Under these five goals, HHS highlights specific actions useful to policy makers at every level of government. The report provides comprehensive strategies that policymakers can take to improve quality of care not only for minorities, but ultimately for everyone who needs health care.  

Following the message behind their Action Plan, the theme for this year’s Minority Health Month is “Health Equity Can’t Wait. Act Now in Your CommUnity” to emphasize the importance of community-based initiatives in improving access to and quality of health care.  For more information on events for this month, visit the HHS Office of Minority Health’s website.

The National Institute of Health is also celebrating the month through its first NIH Minority Health Promotion Day, sponsored by the National Institute of Minority Health and Health Disparities, on April 19^th. Various exhibits and speakers will present how social and economic factors contribute to and maintain health disparities in our health care system.

For state policymakers, Minority Health Month provides a great opportunity to raise awareness around the importance of quality health care access and a good time to promote efforts to improve that access in communities across the states.  For results based policy solutions to ensure that all children are healthy, visit PolicyforResults.org.