Medicaid: Difference between revisions

The ACA was structured with the assumption that Medicaid would cover anyone making less than 133% of the Federal poverty level throughout the United States; as a result, premium tax credits are only available to individuals buying private health insurance through [[Health insurance marketplace|exchanges]] if they make more than that amount. This has given rise to the so-called [[Medicaid coverage gap]] in states that have not expanded Medicaid: there are people whose income is too high to qualify for Medicaid in those states, but too low to receive assistance in paying for private health insurance, which is therefore unaffordable to them.<ref>{{cite webnews | url=https://psmag.com/social-justice/the-medicaid-coverage-gap-persists | title=The Medicaid Coverage Gap Persists | work=Pacific Standard | date=26 January 2016 | accessdate=7 March 2016 | author=Gunn, Dwyer}}</ref>

A 2017 survey of the academic research on Medicaid found it improved recipients' health and financial security.<ref name=":1" /> Studies have linked Medicaid expansion with increases in employment levels and student status among enrollees.<ref>{{Cite journal|last1=Tipirneni|first1=Renuka|last2=Ayanian|first2=John Z.|last3=Patel|first3=Minal R.|last4=Kieffer|first4=Edith C.|last5=Kirch|first5=Matthias A.|last6=Bryant|first6=Corey|last7=Kullgren|first7=Jeffrey T.|last8=Clark|first8=Sarah J.|last9=Lee|first9=Sunghee|last10=Solway|first10=Erica|last11=Chang|first11=Tammy|date=2020-01-03|title=Association of Medicaid Expansion With Enrollee Employment and Student Status in Michigan|journal=JAMA Network Open|language=en|volume=3|issue=1|pages=e1920316|doi=10.1001/jamanetworkopen.2019.20316|pmc=7042869|pmid=32003820|doi-access=free}}</ref><ref>{{Cite journal|last1=Hall|first1=Jean P.|last2=Shartzer|first2=Adele|last3=Kurth|first3=Noelle K.|last4=Thomas|first4=Kathleen C.|date=2018-07-19|title=Medicaid Expansion as an Employment Incentive Program for People With Disabilities|journal=American Journal of Public Health|volume=108|issue=9|pages=1235–1237|doi=10.2105/AJPH.2018.304536|issn=0090-0036|pmc=6085052|pmid=30024794}}</ref><ref>{{Cite journal|last1=Hall|first1=Jean P.|last2=Shartzer|first2=Adele|last3=Kurth|first3=Noelle K.|last4=Thomas|first4=Kathleen C.|date=2016-12-20|title=Effect of Medicaid Expansion on Workforce Participation for People With Disabilities|journal=American Journal of Public Health|volume=107|issue=2|pages=262–264|doi=10.2105/AJPH.2016.303543|issn=0090-0036|pmc=5227925|pmid=27997244}}</ref> A 2017 paper found that Medicaid expansion under the Affordable Care Act "reduced unpaid medical bills sent to collection by $3.4 billion in its first two years, prevented new delinquencies, and improved [[credit score]]s. Using data on credit offers and pricing, we document that improvements in households' financial health led to better terms for available credit valued at $520 million per year. We calculate that the financial benefits of Medicaid double when considering these indirect benefits in addition to the direct reduction in out-of-pocket expenditures."<ref>{{cite journal|last1=Brevoort|first1=Kenneth|last2=Grodzicki|first2=Daniel|last3=Hackmann|first3=Martin B|date=November 2017|title=Medicaid and Financial Health|url=https://www.nber.org/papers/w24002|journal=NBER Working Paper|series=Working Paper Series |publisher=National Bureau of Economic Research|pages=24002|doi=10.3386/w24002|doi-access=free}}</ref> Studies have found that Medicaid expansion reduced rates of poverty and severe [[Food security|food insecurity]] in certain states.<ref>{{cite journal|last1=Zewde|first1=Naomi|last2=Wimer|first2=Christopher|date=January 2019|title=Antipoverty Impact Of Medicaid Growing With State Expansions Over Time|journal=Health Affairs|volume=38|issue=1|pages=132–138|doi=10.1377/hlthaff.2018.05155|pmid=30615519|s2cid=58641724 }}</ref><ref>{{Cite journal|last=Himmelstein|first=Gracie|date=2019-07-18|title=Effect of the Affordable Care Act's Medicaid Expansions on Food Security, 2010–2016|journal=American Journal of Public Health|volume=109|issue=9|pages=e1–e6|doi=10.2105/AJPH.2019.305168|issn=0090-0036|pmc=6687269|pmid=31318597}}</ref> Studies on the implementation of work requirements for Medicaid in Arkansas found that it led to an increase in uninsured individuals, medical debt, and delays in seeking care and taking medications, without any significant impact on employment.<ref>{{Cite web|url=https://www.latimes.com/science/la-sci-arkansas-medicaid-work-requirements-backfire-20190619-story.html|title=Arkansas' Medicaid work requirement left people uninsured without boosting employment|last=Galewitz|first=Phil|website=[[Los Angeles Times]]|access-date=2019-06-22|date=June 19, 2019}}</ref><ref>{{Cite journal|last1=Sommers|first1=Benjamin D.|last2=Goldman|first2=Anna L.|last3=Blendon|first3=Robert J.|last4=Orav|first4=E. John|last5=Epstein|first5=Arnold M.|date=2019-06-19|title=Medicaid Work Requirements — Results from the First Year in Arkansas|journal=New England Journal of Medicine|volume=381|issue=11|pages=1073–1082|doi=10.1056/NEJMsr1901772|pmid=31216419|issn=0028-4793|doi-access=free}}</ref><ref>{{Cite journal|date=2020|title=Medicaid Work Requirements In Arkansas: Two-Year Impacts On Coverage, Employment, And Affordability Of Care|url= |journal=Health Affairs|doi=10.1377/hlthaff.2020.00538|last1=Sommers|first1=Benjamin D.|last2=Chen|first2=Lucy|last3=Blendon|first3=Robert J.|last4=Orav|first4=E. John|last5=Epstein|first5=Arnold M.|volume=39|issue=9|pages=1522–1530|pmid=32897784|pmc=7497731}}</ref> A 2021 study in the ''American Journal of Public Health'' found that Medicaid expansion in Louisiana led to reductions in [[medical debt]].<ref>{{Cite journal|last1=Callison|first1=Kevin|last2=Walker|first2=Brigham|date=2021|title=Medicaid Expansion and Medical Debt: Evidence From Louisiana, 2014–2019|journal=American Journal of Public Health|volume=111|issue=8|pages=e1–e7|doi=10.2105/AJPH.2021.306316 |pmc=8489609 |pmid=34213978|s2cid=235724057|issn=0090-0036|pmc-embargo-date=August 1, 2023 }}</ref>