The Wall Street Journal published a story on how some states might partially expand Medicaid under the new health care reform law, rather than implementing a complete overhaul. Will Texas join these states? Governor Rick Perry said Texas won’t expand the Medicaid program or set up state insurance exchanges.
Indiana, New Mexico and Wisconsin are among the states asking the federal government to let them omit from the Medicaid expansion residents whose incomes put them just above the poverty level. The states hope to take advantage of provisions in the Affordable Care Act that offer a federal subsidy to help these residents buy private insurance, starting in 2014.
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Under the law, all states were to open their Medicaid programs to Americans who earned up to 133% of the federal poverty level, which is currently set at $11,170 for a single person. The law also made those with incomes 100% to 133% of the poverty level eligible to buy federally subsidized, private insurance through exchanges.Some states, however, are asking the Centers for Medicare and Medicaid Services if they can include people in Medicaid up to 100% of the poverty level, but keep people with incomes between 100% and 133% of the poverty level out of the program and instead funnel those people toward the exchanges….Their main reason: States wouldn’t have to contribute to the costs of the subsidies to purchase private insurance.
According to WSJ, hospitals say Medicaid expansion would leave them with more non-paying patients.
In other Medicaid news, the Texas Tribune reports contention among lawmakers about the expansion of managed care. In expanding the program to South Texas, lawmakers reduced reimbursement rates for dual eligibles and created a budget that excluded enrollment growth. Of course, this will exacerbate the primary care physician shortage.
