The Opposite of Portable Insurance

The Affordable Care Act (ACA) creates two new subsidies in an attempt to insure 32 million people: expanded Medicaid eligibility and subsidized insurance sold in a health insurance exchange. Yet there’s a fire wall between the two. If you are eligible for Medicaid, you can’t be in the exchange and vice versa. A new study in Health Affairs suggests than an administrative nightmare is just around the corner:

The law specifies no minimum enrollment period, and subsidy levels will also change as income rises and falls. Using national survey data, we estimate that within six months, more than 35 percent of all adults with family incomes below 200 percent of the federal poverty level will experience a shift in eligibility from Medicaid to an insurance exchange, or the reverse; within a year, 50 percent, or 28 million, will.

Comments (6)

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  1. Joe S. says:

    Thanks for posting this. This whole thing is going to be a complete zoo.

  2. Bruce says:

    Truly bizarre. What do you suppose Congress was thinking about when they passed this montrosity?

  3. Devon Herrick says:

    There is significant churn in Medicaid, with people moving in and out of eligibility frequently. For instance, on any given day there is something like 45 million people on Medicaid but there were closer to 60 million unique enrollees last year. The paper in Health Affairs explains what this means people will continually experience a change in status of which program they are eligible for. This could create a nightmare sufficient to cause many to forgo coverage entirely unless they become sick.

  4. Tom H. says:

    This is quite remarkable. I don’t think most proponents of Obama care have ever thought about this.

  5. Vicki says:

    Why is no one talking about this? This is incredible.

  6. Paul H. says:

    This is a very important result. It shows how little thought actually went into the design of ObamaCare