Category : General

Posted : Tuesday, June 29, 2021
Edited By : Strong Family
Thursday, September 16, 2021

Medicaid Expansion

Strong Family

Last year, lawmakers in 14 states elected to expand their medicaid coverage under the Affordable Care Act guidelines. This means that medicaid benefits will go beyond the elderly, disabled and children; a decision that will add over $100 million dollars to each state’s expenses each year. With better healthcare for the most vulnerable populations, it could be worth the cost.

While most states have already implemented the changes, Oklahoma and Missouri elected to postpone their adoption of the expansion until July 1st of this year. Oklahomans can expect to see these changes coming into effect on July 1st. Late in April, the Missouri State Senate made a late night vote to refuse funding for this expansive program. Georgia also elected to postpone their expansion until at least August.

For most low income Oklahoman’s, this expansion will be a welcome safety net during a transitional time in history, for others, it’s another ill advised spending spree. So let’s dive in and talk about what Medicaid Expansion means for Oklahomans, how the state is funding this and why this is such a controversial subject.

Check out our YouTube Video on this topic!

We’ll go ahead and start at the beginning with The Affordable Care Act. In 2010, President Obama signed the ACA into law, radically expanding insurance coverage for many Americans. Also known as Obamacare, this legislation provided significant changes to how insurers interacted with consumers. It also created a large amount of controversy due to the potential for higher premiums, and fines for the uninsured. 

A controversial and prevalent part of the ACA was an expansion of the state run Medicaid programs. Using incentives and penalties, the Affordable Care Act has pushed for each state to include all low income individuals in Medicaid. Much of the funding comes from the federal government, but as stated before, it adds a significant burden to state budgets. 

As of June 2021, 39 States have voted to expand their Medicaid program under the Affordable Care Act guidelines. 10 of those states only just voted in October of 2020 to make the immensely popular change. Of those 10, 8 immediately enacted their expansion. Missouri and Oklahoma chose to wait until July 1st to put this legislation into effect. 

It’s not all smooth skies and rainbows though. Just this week, a Missouri judge struck down the law voted on late in 2020. 

This judge’s decision came after Gov. Mike Parson refused to allocate funds for the program, citing an unmanageable $130 million dollar price tag. A lawsuit is being brought to the Missouri Supreme Court in response to this decision in order to appeal it and continue with expansion. For many in the state, this delay can mean the difference between getting life saving care or not.

For Missouri it remains to be seen whether Medicaid expansion will stick, but in Oklahoma the gears are already turning. 

The main change to medicaid is the addition of adults age 19-64 onto the program. As of July 1st in Oklahoma, anyone making $17,000 or less as an individual, or $34,000 as a family of four is going to see big changes in their access to medical services. 

An additional change, coming in October of 2021, called Sooner Select, will also include the Medicaid expansion population. This program partners with doctors, dentists and other healthcare providers to provide SoonerCare recipients a robust network of care. 

Some of the benefits Oklahomans can look forward to are better access to physicians, improved diabetes control, an average reduction of $1,140 in medical bills, as well as a 55% reduction in hospital uncompensated care costs. These benefits will not only be felt by the individual, but the Oklahoma taxpayer may see a reduction in hospital costs.

Registration opened on June 1st, and in the weeks since, over 50,000 people have applied. An expected 200,000 are expected to enroll throughout the rest of 2021. 

While some argue that the expansion will be a burden on state budgets, others claim that the program will be a net savings for most states that opt in. There’s also the issue of losing out on coverage. 

While the Medicaid coverage is a welcome safety net for many Americans, it also provides an income ceiling for its recipients. Due to the income requirements of the program, participants are discouraged from increasing their income beyond the $17,000 level, furthering a cycle of poverty. When health insurance is only provided when income is low, it becomes increasingly difficult to justify earning more.

And then there are the private insurers.

Many of the medicaid Managed Care Organizations are the same insurance companies that you know and love: Centene, Aetna and WellCare just to name a few. These companies act as the mediators for the state’s medicaid program. They provide coverage networks and doctors, and then they bill the state. Many of them profit greatly from their position as the go-between, and likely lobbied heavily to make this expansion happen, both in 2010 and today. 

Sadly these companies aren’t always benevolent actors. One company was even fined for overcharging states millions of dollars in falsified transactions through a subsidiary drug company.

Whether you agree with these changes or not, knowledge is power. Knowing what is available for yourself, your family, and your business allows you to best navigate your financial situation. 

For any questions about Medicaid, Medicare or Insurance in general, be sure to call our office and talk to an expert agent 5 days a week.

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