Health coverage for the poorest Americans could be in jeopardy in many states as a result of the U.S. Supreme Court's ruling last month on the Affordable Care Act, according to a new legal analysis. The report examines federal and state Medicaid options following the United States Supreme Court's ruling in NFIB v Sebelius and appears in the August issue of the journal Health Affairs.
"Some states will use the court's decision as an excuse to delay or refuse to participate in the expansion of Medicaid as outlined in the Affordable Care Act," says lead author of the report, Sara Rosenbaum, Harold and Jane Hirsh Professor of Health Law and Policy, George Washington University School of Public Health and Health Services in Washington, D.C. "The ruling allows states to decline the expansion yet still continue to collect federal funding to operate a status quo Medicaid program, leaving millions of impoverished children and adults at risk for lack of coverage."
At the same time, the expansion would create new jobs as federal funding to pay for health care begins to flow into poor communities. Between 2014 and 2016 the federal government will pay for 100 percent of the cost of the Medicaid expansion and 90 percent of the costs by 2020 and thereafter. That influx of federal funds would represent a much-needed boost to thousands of communities affected by poverty, elevated unemployment and other signs of economic distress, according to the analysis.
In the end, the economic benefits of going forward might sway states that have been opposed to the expansion in the past. And the analysis notes that states that still balk may face considerable political opposition and an outpouring of concern from consumers, insurers, local governments, and health care providers. States that still refuse to set up the expansion will have to explain why they are turning away a "boatload of federal funds designed to cure Medicaid's greatest flaw," Rosenbau
|Contact: Kathy Fackelmann |
George Washington University