The Medicaid expansion increases Medicaid coverage to individuals up to 133% of the Federal Poverty Line and includes groups of people not currently eligible (e.g., childless adults). If the Medicaid expansion is maintained, it means that the Medicaid population nationwide will grow by an estimated 16 – 18 million people (approximately half of the number of people currently uninsured). This will increase the number of people with access to prescription drugs, medical devices and other technologies. However, given that Medicaid reimbursement rates vary from state-to-state and many states are facing fiscal challenges, many are concerned that Medicaid coverage will prove inadequate and may not increase access to care, therapies, and devices as much as is hoped. If the Medicaid expansion is struck down and the individual mandate upheld, it is unclear where and how these individuals will secure health insurance coverage. Some may seek coverage through the state exchanges but many not qualify for a federal subsidy since the ACA presupposed this group of individuals would be covered by Medicaid.
To read about what the Medicaid expansion means to patients and providers, click here.