CURRENT SERIES:
Healthcare Reform Stakeholders Summit, Fall 2015
NOW PLAYING
Implications of State Decisions to Expand or Not Expand Medicaid
1 of 15
October 27, 2015
October 27, 2015
December 30, 2015
December 30, 2015
December 30, 2015
December 30, 2015
January 25, 2016
January 25, 2016
January 25, 2016
January 25, 2016
February 12, 2016
February 12, 2016
February 12, 2016
February 12, 2016

Implications of State Decisions to Expand or Not Expand Medicaid

Medicaid expansion is one of the most controversial parts of the Affordable Care Act, and state decisions not to expand the program impacts the healthcare industry and residents, say panel members Leah Binder, Austin Frakt, PhD, Margaret E. O'Kane, MHA, and Matt Salo in the first segment of the Healthcare Reform Stakeholders Summit, held in September 2015.


The decision to expand or not expand Medicaid has had implications across the healthcare industry, and there are some results that are not entirely unexpected, explained Austin Frakt, PhD. For instance, studies have found that in non-expansion states, health insurance coverage rates are lower and grow slower than in expansion states. Additionally, the choice not to expand the federal program means a state is missing out on federal dollars, he said.

“So states that haven’t expanded, they’re not benefiting from that,” Dr Frakt said. “So you’re seeing hospitals with tighter margins, maybe negative margins, some closures in rural areas, and the state in general is not getting an economic boost that it would otherwise.”

The question is not so much “should we expand coverage?” as much as it is “what is the best way to go about bringing new insurance coverage to low-income Americans,” said Matt Salo. So even before the implementation of the Affordable Care Act and state decisions on Medicaid expansion, there were changes happening to state Medicaid programs, such as delivery system and payment reform.

One opportunity is maternity care, Margaret E. O’Kane, MHA, pointed out. More than half of births are in Medicaid, and there are opportunities to improve birth outcomes. Leah Binder echoed the sentiment. Her organization, The Leapfrog Group, has seen early elective deliveries drop through the efforts of some states that have made an effort to align the interests of Medicaid and private sector purchasers.

“It really is about creating the right synergy with the delivery system,” O’Kane said. “And the conditions on the ground in each state are different, and taking advantage of the natural resources that you might have in the state or the natural advantages, I think, is part of the magic.”

 
Copyright AJMC 2006-2019 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up