The Medicaid Opt-Out Threat


As a result of the Supreme Court ruling on the Affordable Care Act several weeks ago, the large effort of Medicaid expansion is now optional in any state. Currently, a handful of Republican governors are doing their part to take advantage of this option, with Florida and Texas intent to bring down their Medicaid budgets on a massive scale. Florida Governor Rick Scott announced on national television his rejection of Medicaid expansion shortly after the ruling, which will have a huge impact on the uninsured population.

With millions of Floridians lacking health insurance, this will be devastating to the effort set out by the Obama Administration to provide every American with health care coverage. As many individuals don’t have coverage because they cannot afford it, Medicaid has long been the go-to for low-income families and medically needy persons.

Given the weight that both health care reform and the state of Florida have on the 2012 election, Governor Scott’s move adds yet another Republican threat to the race. Many Florida supporters of the ACA see the expansion of Medicaid as a necessity on both moral and economic levels, given the vast population it affects.

Though the governor has made the rejection statement for Florida Medicaid, there is no official statement from leaders of Republican-operated state Legislature. They have states they plan to look over their options in the next few months before reaching an ultimate conclusion.

Incoming House speaker Representative Will Weatherford stated, “At the end of the day, we are going to take a rational approach that reflects the interests of Floridians, protects their hard-earned tax dollars and uses common sense. ”

The future of Medicaid is looking a bit shaky due to the opt-out possibility, as well as the threat of cutting people who are currently using the program. The original laws in the Affordable Care Act contained no such information, but after the Supreme Court got their hands on it, Medicaid got the worst of the ruling.

“The impact of the high court’s ruling making the expansion voluntary is likely to be compounded by another provision in the law that the justices left intact: In 2014, states are no longer barred from making it harder for adults to qualify for Medicaid. Experts worry those two developments taken together could spur some states to reduce the number of people covered” (Galewitz, Kaiser Health News).

This places low-income adults in quite a predicament, and ultimately reverses the effect of the ACA on Medicaid. Giving more care to more individuals was the root of the law, which now is seeing some very big changes and complications. Federal subsidies for health insurance will still be offered to those who earn income from 100 to 400% of federal poverty level. Due to the option of subsidies, states would be able to set Medicaid eligibility at 100% of FPL instead of 133%.

While all of these puzzle pieces are being put together somewhat haphazardly, there is still no definitive answer for the future of Medicaid and low-income adults without insurance. With the current ruling of the Supreme Court left to state and federal government powers to create new policies and procedures, there will be much controversy and difficulty in months and years to come.

The attempt to create fair and equal health care systems is not looking successful, but hopefully there will still be enough funding for individuals to get health care when it becomes mandatory.

Thanks America!


About B. Somers

B. Somers is a contributor to Health Insurance News, focusing on medical coverage, carriers, health reform and the conflicts surrounding insurance. Writing for the company's sites has provided a strong introduction to health insurance, and the opportunity to gain knowledge in the insurance industry.