As Nebraska continues to debate the issue of expanding Medicaid to cover adults under 65 with income up to 133% of the federal poverty level in Nebraska, there are some important considerations on why this can improve health outcomes in our state.
Medicaid is already an important source of health insurance coverage for patients with heart disease, stroke, and other cardiovascular diseases (CVD), and through Medicaid expansion, it will become an even more important source of coverage for currently uninsured adults with or at-risk for CVD. Of the more than 41 million uninsured adults in 2010, more than half (52%) would be eligible for Medicaid coverage under the expansion because they have incomes under 138% of poverty. Most of these uninsured are working adults in low-wage jobs who either aren’t offered employer coverage or cannot afford their share of the cost. Expanding Medicaid coverage will cover more Americans and help to reduce the devastating impact of health care costs on our economy.
Expanding Medicaid is not just beneficial to patients with chronic disease; it also a good deal for states, health care providers, consumers, and employers. The federal government will pick up 100% of the costs of Medicaid expansion for the first 3 years (2014-2016). Going forward permanently, the federal government will cover at least 90% of the costs. A number of independent analyses have estimated that state Medicaid spending would increase only 1.1% to 1.4% between 2014 and 2019.[i] In states that opt not to expand Medicaid, their taxpayers will be subsidizing the cost of expansion for those states who do, while receiving none of the benefits.
Much of a state’s costs for expanding Medicaid will be offset by reducing state and local spending for hospital care for the uninsured. In 2008, state and local governments picked up $10.6 billion, or nearly 20 percent, of the cost of caring for uninsured people in hospitals, according to the Urban Institute.
Covering more of the uninsured through the Medicaid expansion will reduce the amount of uncompensated care that hospitals and other health care providers provide. The American Hospital Association estimated that uncompensated care cost U.S. hospitals alone $39.1 billion in 2009.
As the issue of Medicaid expansion is debated during the 2015 legislative session, we encourage our advocates to raise your voice with your senators and ask for their support so that more people have access to health care coverage.
[i] Matthew Buettgens, Stan Dorn and Caitlin Carroll, “Consider Savings as Well as Costs: State Governments Would Spend at Least $90 Billion Less with the ACA than Without It from 2014 to 2019,” The Urban Institute, July 2011. And Lewin Group, “Patient Protection and Affordable Care Act (PPACA): Long Term Costs for Governments, Employers, Families and Providers,” Staff Working Paper # 11, June 8, 2010.