Eliminating The Medicaid Expansion May Cause More Damage Than Congress Realizes

The American Health Care Act (AHCA) and the Senate’s ill-fated Better Care Reconciliation Act (BCRA) attempted to deliver on two promises: 1) protecting patients with preexisting conditions, and 2) eliminating the Medicaid expansion. Though repeal efforts seem to have stalled for the time being, future GOP attempts to replace the ACA will undoubtedly involve the delicate task of appeasing conservative party members while maintaining provisions of the ACA that remain immensely popular with voters. While others have already discussed the failings of the proposed legislation with respect to the Medicaid expansion and preexisting condition protections, most analyses have overlooked a subtle connection between these two facets of the ACA. We worry that if Congress eventually revives its plan to phase out the Medicaid expansion, many marketplace enrollees with preexisting conditions will find their protections eroded and coverage rendered worthless. Discriminatory Benefit Design in the Marketplace Previous work has already established that patients in Medicaid non-expansion states face higher premiums than their counterparts in expansion states. With the elimination of the expansion, we similarly expect to see premium increases as high-cost enrollees sign up for marketplace plans after losing their Medicaid coverage. But this represents only one way that the rollback of the Medicaid expansion could affect patients in the health insurance marketplace. With the loss of the expansio...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Featured Following the ACA Medicaid and CHIP HIV/AIDS medicaid expansion states Source Type: blogs