A group of U.S. senators is calling for the federal government to offer health coverage to people who would be eligible for Medicaid coverage if their state expanded the program under the Affordable Care Act (ACA), but whose states have not done so.
Under the ACA, the landmark federal health care law passed by Congress and signed by President Barack Obama in 2010, all states were supposed to expand eligibility for Medicaid — the joint federal-state public insurance program for low-income people that is administered by each state separately — to cover all U.S. citizens and legal residents with income up to 138% of the federal poverty line. This expansion was to begin in 2014, with the federal government covering 100% of the cost of providing additional coverage under the program that year through 2016, then paying a slightly smaller share of the cost each following year until 2020 and after, when the federal government would pay 90% of the cost of expanded coverage. But a U.S. Supreme Court ruling in 2012 made Medicaid expansion optional for each state. Given the strong financial incentives to do so, most states expanded Medicaid as the ACA intended — after all, federal money for Medicaid expansion supports local hospitals and other health care providers that would otherwise provide more uncompensated care for people without health insurance, passing the cost on to everyone else. But 12 states still have not adopted Medicaid expansion, according to the Kaiser Family Foundation, leaving many low-income people without health coverage.
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Senators introduce legislation to expand Medicaid
In an effort to fill this gap in health insurance coverage, a trio of U.S. senators has introduced legislation that would have the federal government offer Medicaid-like health insurance to residents of states that haven’t expanded the program — and cover as many as 2 million more people throughout the country, according to an article on the proposal at The Hill. Under the proposal by Senators Raphael Warnock and Jon Ossoff of Georgia and Tammy Baldwin of Wisconsin, all Democrats, each person’s coverage under the new federal initiative would look very similar to Medicaid coverage in their state — offering the same essential health benefits without charging any premiums or large copayments. But it would be administered by the federal government rather than by states. What’s more, this coverage wouldn’t require budgeting any additional money, since Congress already budgeted for Medicaid expansion in all 50 states when it passed the ACA.
“For too long leaders in Georgia and the other non-expansion states have put politics over people, refusing to strengthen public health by expanding Medicaid,” said Senator Warnock in a press release from the offices of the three senators. “I believe health care is a right, and the Medicaid Saves Lives Act would ensure Georgians and other Americans with low incomes who would qualify for Medicaid in most other states finally have access to the health care they need to keep our communities and economy moving forward.”
According to the press release, the proposed legislation would also give states additional financial incentives to expand Medicaid. But in the current political environment, the senators noted, many states appear determined not to expand Medicaid no matter how little it costs them — or how great the costs are of not expanding the program. For example, several non-expansion states have already seen hospital closures that might have been prevented by the increased federal funding provided by Medicaid expansion. In Georgia alone, nine hospitals have closed in the last decade, leaving many rural areas without a nearby hospital.
“Our legislation will open the door to those who have been shut out and expand access to affordable health care, including preventive care, that people want and need,” said Senator Baldwin in the press release. “I look forward to working in the Senate to pass this legislation and overcome the obstruction we have faced for far too long.”
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