Effective Medicaid Expansions Remain Unclear

The jury is still out as to what the effect will be of the Medicaid expansion that is called for within the provisions of the Patient Protection and Affordable Care Act ("PPACA"). The expansion was originally to be required of all U.S. states, but, after the Supreme Court held that expansion could only be made voluntarily, the impact of the expansion was deflated considerably.

With an effective date of January 1, 2014, many states are wrestling with the idea of whether they want to expand their Medicaid programs or keep them as they are now. If every state were to accept the expansion, it is estimated that the $2.8-trillion U.S. healthcare system would acquire 16-million new patients. So far, however, just around 22 state governors, including four Republicans, have expressed support for the expansion, while 13 Republican governors have expressed opposition to the expansion, citing cost and intrusion by the federal government into state's issues as the reasons.

The PPACA expansion would open up eligibility to the nation's poor who are making less than 133% of the federal poverty rate. In dollars, that percentage equates to an annual income of about $24,000 for a family of three. Additionally, the PPACA would set the eligibility requirements across the nation instead of each state determining its own eligibility requirements, as is done in the current system.

If a state does oppose the PPACA's expansion of Medicaid it can continue to receive matching federal funds for its current system.

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