The Obama administration is trying to convince states to expand Medicaid, but a proposed policy intended to make that easier may result in millions of people paying more for health insurance. The policy would allow states to charge higher premiums and co-payments for medical services, including prescription medicine and “nonemergency use” of hospital emergency departments.
As a result of the health care law passed in 2010, Medicaid was extended to adults without children and other people who had not been eligible before, but the Supreme Court ruled that the expansion was optional for states. The administration is encouraging states to take that option by making it easier for states to charge patients more and thus hold down the cost to states. Under the proposed policy, a three-person family with a $30,000 yearly income could pay up to $1,500 in co-payments and premiums.
Critics contend that it will be difficult for low-income families to bear the extra cost, and that the “nonemergency use” of emergency services is not well-defined. Medicaid patients may have a reasonable belief that a particular condition constitutes an emergency, but this may not be borne out in the diagnosis.
Approximately 60 million people are covered by Medicaid, and that is expected to increase by more than 11 million as new patients qualify under the 2010 health care law. More than half of Medicaid costs are paid for by the federal government, and it will pay an even greater share for the newly eligible patients.