NCPA - National Center for Policy Analysis

Expanding Medicaid Will Harm Enrollees

March 4, 2014

Those who most need Medicaid could be hurt by state expansions of the program, says Angela Boothe, a health care policy analyst with the American Action Forum.

ObamaCare encourages states to expand Medicaid to those up to 138 percent of the federal poverty line by providing states with matching funding.

While touted by the administration as a financial benefit to states, the expansion will increase state costs in the long run, all while hurting current Medicaid enrollees.

  • More people will seek treatment through a system that is already in trouble. Medicaid has been shown not to improve health outcomes, and adding more people to a program that is already not producing results will only hurt those currently in the system.
  • Reimbursement for medical care is much lower for Medicaid than for private insurance and Medicare. Doctors will stop accepting new Medicaid patients, lowering access to care and putting strain on doctors who do receive Medicaid patients.
  • Those already enrolled in Medicaid will have to compete with these new enrollees for services. Waiting lists for some Medicaid services already exist, and such lists will only grow with additional enrollees.
  • While the federal matching funds start at 100 percent and drop to 90 percent, the matching is not a guarantee. Budget pressures could always reduce those funding levels, and states will be left to fund the remaining portion. State budgets are already overwhelmed with Medicaid costs as it is.

Medicaid should be focused on helping the most vulnerable populations, and any changes to the program should work to improve health outcomes and rein in costs. Bringing more individuals into the system will only put further strains on a program already struggling to care for those currently enrolled.

Source: Angela Boothe, "Expanding Medicaid -- Harming Those Who Need it Most," American Action Forum, February 19, 2014.


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