ObamaCare to Increase Disruption and Discontinuity of Care for Low-Income Americans
A new Health Affairs study:
- P
re-ObamaCare, approximately half of low-income adults might have experienced a change of circumstances that caused churn between Medicaid and private coverage each year. - Higher-income states and states that had more generous Medicaid eligibility criteria for nonelderly adults before the ACA experienced more churning.
- Under ObamaCare, more than 40 percent of adults likely to enroll in Medicaid or subsidized exchange coverage would experience a change in eligibility within twelve months.
Why is this important? Because people who are eligible for Medicaid are not allowed to get private, subsidized insurance in the exchange and vice versa.
The authors’ recommendation:
Policy options for states to reduce the frequency and impact of coverage changes include adopting twelve-month continuous eligibility for adults in Medicaid, creating a Basic Health Program, using Medicaid funds to subsidize Marketplace coverage for low-income adults, and encouraging the same health insurers to offer plans in Medicaid and the Marketplaces.
A better solution? Universal, refundable tax credits that allow every American, at any income level, to choose and purchase individual, portable, health insurance with continuous coverage. It’s described here.
“A better solution? Universal, refundable tax credits that allow every American, at any income level, to choose and purchase individual, portable, health insurance with continuous coverage.”
Now that’s the ticket!
I agree. That sounds ideal. With refundable tax credits allowing every American to choose and purchase health insurance should help reduce frequency of coverage changes.
This proposal gives choices to the people, treats them equally and allows individuals to afford an insurance that suits their needs. It is one that is aligned with the American ideals and that will have a positive reaction from people from the left and people from the right.
Presented the argument like this, it will surely win several followers to Dr. Goodman’s plan. A single policy can help solve several of the inconveniences that ACA has created or were preexistent but the reform didn’t address them.
I think this plan could win over many followers. Presentation is key, and presenting it in a way to show long term change to ACA for viable change.
Sometimes is more important to have a good marketing department than have good ideas. Obama’s administration has survived the public opinion storm because it has a marketing department that effectively handles every criticism. The Republicans should adopt Goodman’s idea (to at least have something to fight for) and start investing in its marketing. That way the public will not only know the issues with Obamacare, but they will have an alternative.
If there was churning before and after the reform, can we blame Obamacare? Maybe the restrictions imposed in the program are what cause this problem, so we might want to check that before we change anything else.
I think it’s become pretty clear to pretty much everyone that Obamacare has increased the complexity and fragmentation of health-insurance coverage.
Thank you for your comments. I think it’s become pretty clear to pretty much everyone that Obamacare has increased the complexity and fragmentation of health-insurance coverage.