Medicaid, a government insurance program designed to provide healthcare coverage for low-income Americans, including the elderly, the disabled, and children, existed before the implementation of Obamacare (the Affordable Care Act, or ACA) and it continues to help many low-income families and individuals receive necessary healthcare. However, who is eligible for coverage and what benefits are received by those covered have changed since the passage of Obamacare. In many cases, coverage is easier to obtain and benefits have been expanded to a greater number of qualified individuals.
The major worry for those already receiving health benefits through Medicaid was that the passage of Obamacare would compromise their coverage. This is not the case. In fact, Obamacare sought to expand Medicaid coverage in a variety of ways. It’s important to understand that Medicaid is a program funded by both federal and state government. Under Obamacare, states were urged to expand their funding for Medicaid in order to provide coverage for more low-income adults and families. States that elected to do so were paid by the federal government for 100% of expansion costs for the first three years, and those that decide to keep the expanded coverage after that period will receive payment for 90% of expansion costs until 2022. Still, many states have not expanded their Medicaid coverage and some still have no plans to do so.
What does this mean for needy individuals? It depends. Medicaid coverage is still available in every state for those who qualified for care before Obamacare took effect, including senior citizens, children, and disabled individuals. For states that have expanded coverage, even more individuals and families are covered based on a more generous income threshold and other factors. Criteria for qualification, however, many depend on your household income and size, the state you live in, and other factors (such as age). The Children’s Health Insurance Program (CHIP) is available in every state, but other Medicaid benefits may not be available everywhere – it depends on whether or not your state of residence has decided to extend coverage under Obamacare or not.
States that have yet to extend coverage generally claim that the high costs associated with expansion of the program are untenable. Although the federal government will cover costs for expansion at first, eventually states will bear some of the burden of paying for additional coverage and services provided under the Medicaid expansion. Proponents claim that providing essential and preventive services will actually reduce costs over time, but many states are still hesitant to expand. With additional individuals and families becoming eligible for Medicaid coverage and doctors now receiving payment (commensurate to Medicare) for services rendered to individuals and families with Medicaid, some states are nervous about future costs. However, forecasts indicate that costs will decline over time, perhaps even coming out in a wash as emergency services become less necessary due to an increase in preventive care.
As for the services available to those eligible for Medicaid, they are also expanding. Because Medicaid coverage encourages prevention services (thus eliminating the high costs of emergency service), Medicaid users could now receive access to increased testing, as well as counseling and support services intended to help patients achieve better health (weight loss, addiction counseling, etc.). Hopefully, states that have yet to implement expansion for Medicaid will stop dragging their feet. Until then, citizens can and should contact their state legislature and representatives in order to voice support for Medicaid expansion.