Expanding Medicaid: Mind the Gaps

In mid-January, the results of a 50-state survey were released by the nonpartisan Kaiser Family Foundation. These results showed that the current way of administering Medicaid, the $490-billion government program that provides healthcare coverage to the nation’s poor and disabled, has resulted in rather large gaps regarding who it covers.

According to the survey, 33 states require that parents earn less than the federal poverty rate. It also found that 16 states have an eligibility cutoff that disqualifies parents who earn 50% or more of the federal poverty rate.

Wholly aside from the mish-mash of eligibility based on poverty is the extent of coverage offered from state-to-state. In that regard, Kaiser’s survey found that nine states provide full Medicaid coverage to adults who have no dependent children; but, three states – specifically, Hawaii, Minnesota and Illinois – decreased Medicaid eligibility for adults even when the federal rules did not require such action to be taken.

Despite the current state of Medicaid administration and the patchwork of eligibility restrictions, as the recently upheld provisions of the Patient Protection and Affordable Care Act (PPACA) begin to take effect, experts expect that new eligibility requirements will make it easier for many poor Americans to get coverage. The PPACA’s Medicaid expansion will open up coverage to those people earning 133% and below of the federal poverty rate. The expansion will not occur everywhere, however, as only 22 state governors (including four Republicans) have stated that they favor the expansion, while 13 Republican governors have refused to expand coverage in their states.