Medicaid expansion has brought an additional 11 million people under this public insurance umbrella. Dr Arthur Vercillo, regional president of Excellus Blue Cross Blue Shield, says that state governments may continue to depend on the private sector to manage Medicaid costs and “get these patients into a system of physicians and hospitals who previously didn’t want to take care of Medicaid patients.”
Some states have opted out of the Medicaid expansion, which is a concern for Francois de Brantes, executive director of the Healthcare Incentives Improvement Institute. “The expansion of Medicaid in many states has been able to capture the layer above the poorest of the poor who have been priced out of the commercial insurance market,” he comments. From a policy perspective, it is difficult to justify leaving individuals out of the health insurance system. States have to realize that “It just doesn’t make a whole heck of a lot of sense [to ignore Medicaid expansion] from a pure economic standpoint, and certainly from a social standpoint,” says Mr de Brantes, adding, “I’ve run out of any ability to explain it.” Dr Vercillo agrees, but says it is a case of politics rather than economics overriding good patient care.
“The ACA was a deal, and like any deal, compromises have to be made,” Mr de Brantes. However, the fundamental premise was to try to provide health insurance for a significant proportion of the population who lacked it for various reasons, such as affordability.