Understanding Medicaid Expansion

KEY ISSUES

American Health Care Act | Insurance Company Mandates | Medicaid Expansion | Tax Credits | Senate Parliamentarian | F.A.Q.

Medicaid is a federal government program designed to help lower-income citizens get health care. It now serves more than 70 million Americans. But costs are high – $532 billion in 2015 – and care is poor. Obamacare drastically expanded Medicaid coverage, pushing able-bodied Americans onto this failing government healthcare program. Rather than repealing Obamacare’s Medicaid expansion immediately, the Republicans’ American Health Care Act includes a three-year delay in freezing Medicaid enrollment, effectively retaining one of Obamacare’s worst aspects for the next three years.

  • Medicaid is the federal-state partnership healthcare program for low-income citizens that delivers dismal results. Research published in The New England Journal of Medicine documents that patients covered by Medicaid actually fare worse than patients with no insurance at all.
  • Prior to the enactment of Obamacare, Medicaid was available to citizens whose income fell below the Federal Poverty Level – $24,300 for a family of four in 2017.
  • Obamacare expanded Medicaid to add able-bodied adults below 138% of the Federal Poverty Level – $33,600 for a family of four in 2017.
  • 31 states have opted to implement the Obamacare Medicaid expansion.
  • The House leadership American Health Care Act leaves Obamacare’s Medicaid expansion in place until 2020.
  • The House leadership bill would also continue to pay for all “continuously covered” adults who enrolled in the Medicaid expansion before the 2020 freeze.
  • Over the next two-and-a-half years, states – including those that have not opted to accept the Medicaid expansion – would have an incentive to enroll as many people as possible in Medicaid before the freeze goes into place.
  • Worse, a freeze that doesn’t take place until 2020 is a freeze that likely will never happen at all – because 2020 is a presidential election year, and pressure to repeal the freeze will rise significantly as 2020 approaches.
  • A stronger solution would be an immediate freeze on Medicaid enrollment. It would also be more effective to send Medicaid dollars to states without the strings attached. This type of arrangement would recognize that states are better able to innovate and use dollars effectively without the federal government’s interference.

Download PDFs:

American Health Care Act One Pagers
American Health Care Act Summary
American Health Care Act Insurance Company Mandates
American Health Care Act Medicaid Expansion
American Health Care Act Advanceable, Refundable Tax Credits
American Health Care Act: Overriding the Senate Parliamentarian