Health Care Questions: What's the argument over "Medicaid Expansion?"

This week, the NCC Blog is attempting to answer some basic questions about the current health care debate, especially as it relates to people with disabilities.

Read the posts so far:

Monday: What's going on? And why?
Tuesday: What's the deal with "Pre-Existing Conditions?"

The next question is ...

What's the argument over the "Medicaid Expansion?"

• One of the provisions of the Affordable Care Act, (ACA, a.k.a.: Obamacare), was a program that enabled states to expand Medicaid to cover people with slightly higher incomes ... individuals with income up to 138% of the poverty line.

• This enabled about $14.5 million more people to qualify for Medicaid who couldn't before ... many of them working people without employer-provided health insurance, too much income to qualify for Medicaid previously, and not enough income to pay for individual insurance on the Affordable Care Act markets.

• The House version of the American Health Care Act would phase out the Medicaid Expansion over a period of x years. This means the federal government would gradually ramp down and finally stop compensating states for coverage of the newly added Medicaid Expansion enrollees. In order to keep covering these people, states would have to find a way to pay for it on their own.

• The Senate version of the AHCA will probably include the same phaseout of the Medicaid Expansion, except possibly sooner, or later, depending on how negotiations between Republican factions in the Senate turn out.

• Some Republicans and conservative policy thinkers have been saying that Medicaid Expansion under Obamacare actually harmed people with disabilities, (see Christopher Jacobs article below). The  argument is that adding more people to Medicaid took resources away from disabled people, causing waiting lists for services. This is completely false, since Medicaid Expansion was paid for by additional federal money, and therefore took nothing away from any other Medicaid recipients.

• On the other hand, if the AHCA does end the Medicaid Expansion, it would create a new funding crunch for participating states, since the federal funding for it would disappear. This could contribute to disability-related services being cut or curbed.

Further reading ...

Obamacare pushes nation's health uninsured rate to record low 8.6 percent
Dan Mangan, CNBC - September 7, 2016

A 50-State Look at Medicaid Expansion
FamiliesUSA - April, 2017

Medicaid Restructuring Under the American Health Care Act and Nonelderly Adults with Disabilities
MaryBeth Musumeci and Julia Foutz, Kaiser Family Foundation - March 16, 2017

House Republican Health Bill Would Effectively End ACA Medicaid Expansion
Matt Broaddus and Edwin Park, Center on Budget and Policy Priorities - June 6, 2017

Special Interests Obscure Truth That Expanding Medicaid Makes Disabled Americans Suffer
Christopher Jacobs, The Federalist - June 7, 2017