The ACA establishes a relative decrease in healthcare costs for some, improve access to healthcare for others, and an improvement of quality of care. While many are impacted by these stipulations, perhaps none are more affected than the elderly. Medicaid is expanding in many states, as well as nationally at a rapid pace thanks to the Act. For example, the Act’s Title III asserts that today’s healthcare system is ensuring Medicaid’s dedication to future generations, and it is doing so by expanding on the state level, as well as the federal level. It is able to do this by ending gross overpayment to insurance companies, allowing money to be funneled back into systems that desperately need it, i.e. Medicaid. This improves healthcare costs because Medicaid is now able to expand on the state level, as well, offering Medicaid to more at an earlier age. Early retirees are now eligible for Medicaid in many states and more doctors are paid better for their services, improves the quality of care individuals receive.
Twenty states in the union have opted not to expand Medicaid, which has left an estimated 3million Americans uninsured. The economics and financial burden of the expansion are often cited as the reason when the public balks at the government’s refusal. From 2014 to 2016, the federal government would cover 100% of the financial burden, leaving the state with no economic disparity. In 2017, the state is accountable for 1% of Medicaid’s cost. Every year, until 2020, the state is held accountable for one more percent of the Medicaid expansion until they are eventually responsible for ten percent. The twenty states that voted that idea down believe they would not even be able to cover that much. In the defense of the states who voted down the opportunity, it does make relative mathematical sense. Right now it has left 3 million Americans uninsured, and while the federal government has offered to put up 100% of the bill, by 2020 it could mean that around 5 million Americans in these states would be uninsured. Many are also outraged by the idea that their tax dollars are funding Medicaid for individuals in a different state, even if their state has not accepted the Medicaid expansion. This is happening because currently and through 2020 and beyond, the federal government is going to help fund the expansion.
What many do not realize, or do not care to research, is the Medicaid expansion also covers low-income adults who are not retired, but simply cannot afford expensive ACA plans, and are in need of other healthcare options. The most important question, then, is whether it is working or not for retirees, as well as these low-income adults in the contexts of the ACA expansion. As of today, it appears in the states that approved this provision, the Medicaid expansion is working and has been working. It has allowed a higher rate of access, included a stronger enrollment in what is now known as the marketplace, and has managed to insure millions of low income Americans, including an estimated 50 million women who now experience low-cost preventative screening. Due to the Medicaid expansion, and the massive response to it, insurers have also finally taken notice that many Americans are low-income and, rather than gouge them for their health, as well as their lives, outside of the marketplace, they have begun doing business inside the marketplace, offering lower and more reasonable deals to individuals who are in the most need of it. Not only has this lessened what some would call the burden on the Medicaid expansion, but it as shown what healthy competition can do in the free market. Thus far, the Medicaid expansion has been so successful; the results have coerced five more states into accepting the expansion.
References
Dalal, M. (2016). To Expand or Not To Expand? The Role of Elite Framing in the Politics of Post-ACA Medicaid Expansion. Ann Arbor: The University of Michigan.
Lanford, D., & Quadagno, J. (2016). Implementing ObamaCare: The Politics of Medicaid Expansion under the Affordable Care Act of 2010. Sociological Perspectives, 109-115.
