Navigation Links
With Health Care Reform, Income Swings May Mean Loss of Coverage
Date:2/3/2011

By Amanda Gardner
HealthDay Reporter

THURSDAY, Feb. 3 (HealthDay News) -- Under the new Affordable Care Act, the health reform package signed into law by President Barack Obama last March, millions of Americans whose income fluctuates during the year may lose health insurance for periods of time as their eligibility for different programs changes.

The authors of a new study appearing in the February issue of Health Affairs estimated that as many as 28 million U.S. adults might "churn" in and out of health insurance programs during the course of a year, sometimes losing coverage more than once.

"It's a critical issue," said Cathy Schoen, senior vice president of The Commonwealth Fund, who was not involved with the study. "You could get a raise or lose a week of work or gain a week, and move in and out of coverage."

The problem is a version of the "churning" in and out of Medicaid that has occurred for years, but with some improvements.

Under the traditional Medicaid system, people shifted between having coverage or not having coverage depending on how much they were making.

Under the Affordable Care Act, Americans can move between two programs: Medicaid, which will now be offered to all those whose income does not exceed 133 percent of the poverty line (about $13,800 per year), and premium subsidies in state-run insurance exchanges, which will be available to people above that dividing line up to 400 percent of the federal poverty level (about $41,500).

But when their eligibility fluctuates, they're likely to lose coverage at least for a period of time.

"The good news with the Affordable Care Act is that, rather than falling off of public coverage into nothing, which is what happens now, there's the potential to have you picked up right away by the exchanges," Schoen said. "But unless you coordinate the plans that are being offered and the networks being offered, you could still have a lack of continuity."

"The [insurance exchanges] and Medicaid worlds don't exactly align so there may be one-to-two month gaps without coverage," added study co-author Dr. Benjamin D. Sommers, an assistant professor of health policy and economics at the Harvard School of Public Health in Boston. "The administrative costs are also huge. And even if there aren't gaps in coverage, Medicaid and the exchange plans could be very different in terms of networks. One month you're seeing a particular doctor, and the next month that person's not in your network."

By taking a look at U.S. Census data from the last five years, Sommers and a colleague estimated that in the first six months, 35 percent of families with incomes below 200 percent of the poverty level ($20,760) will change eligibility while half (28 million) would have crossed the threshold at least once during the first year.

An estimated one-quarter of beneficiaries will likely have their coverage disrupted by crossing the income dividing line at least twice in one year, and 39 percent will over the span of two years, the authors added.

Within four years, up to 38 percent will have their coverage disrupted four times or more, they predicted.

And the authors expressed the concern that some people will just get sick of the aggravation and paperwork, and opt to live without health insurance.

Because income changes are more common among younger, better educated adults, the insurance pool could be deprived of the healthy members it needs to stay financially solid.

There are several ways to remedy the problem, the authors stated, one being to set up a guaranteed minimal enrollment period, say, for 12 months, so people would only be reassessed once a year.

It would also help if there was overlap between the Medicaid and exchanges' programs so people moving from one to the other wouldn't have to change doctors or drug formularies, the authors added.

"It would be easier to fine-tune if it was a continuous program," Schoen said, and it would reduce costs.

More information

The U.S. Department of Health and Human Services has more on the Affordable Care Act.

SOURCES: Benjamin D. Sommers, M.D., Ph.D., assistant professor, health policy and economics, Harvard School of Public Health, Boston; Cathy Schoen, senior vice president, The Commonwealth Fund; February 2011 Health Affairs


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Carolinas HealthCare System Volunteers to Join Navy Rescue Mission in Haiti
2. SXC Health Solutions to Host Fiscal 2009 Fourth Quarter and Year End Results Conference Call
3. A New Website Series Improves Appearance and Health City by City
4. Diet-to-Go Welcomes 2 Key Philadelphia Fitness Centers as Partners-in-Health
5. Quantum Health Appoints Stark as Executive Vice President of Sales
6. New Report: The Internet Has More Influence Over Consumer Health Actions than Traditional DTC Channels
7. Satellite Healthcares Sheila Doss Elected Western Chapters Coordinator-Elect of the American Nephrology Nurses Association
8. Changing the Course of Kids Health
9. Mental Health America Encourages Journalists, Media Professionals to Submit Entries for 2010 Media Awards
10. Idaho House Moves State Closer to Health Care Disaster
11. UNT Health Science Centers Roby Helps Identify Bodies of Chiles Patio 29
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
With Health Care Reform, Income Swings May Mean Loss of Coverage  
(Date:3/24/2017)... Arizona (PRWEB) , ... March 24, 2017 , ... ... Healing Center, Sedona, Arizona’s Premier Center for Shamanic Healing and Spiritual Awakening, ... Luis Delgado, June 9--24, 2017. This sacred and spiritual journey during the ...
(Date:3/24/2017)... ... March 24, 2017 , ... Northridge ... offering treatments for sleep apnea and TMJ at their office. TMJ, or temporomandibular ... specifically the obstructive type, is increasingly being treated at dental offices with newly ...
(Date:3/24/2017)... ... ... who like to educate themselves on current issues and who enjoy gaining knowledge on ... to appreciate and love the "Informed" series, hosted by Rob Lowe. A new ... the world. , Running for charity has become a multi-million dollar enterprise ...
(Date:3/24/2017)... ... March 24, 2017 , ... ... Certified Medical Reiki™ Master in Frederick, MD. Judy says, “I am passionate about ... what is often a very difficult and challenging time.” , A Certified Medical ...
(Date:3/24/2017)... ... ... “Vintage and Harvest A Cultivation of Christian Love” is the creation of published ... with his wife, Anna Marie. He and his wife are the proud parents of ... author of “Shadow and Substance.” , “Love, the agape kind, is seen as more ...
Breaking Medicine News(10 mins):
(Date:3/23/2017)... -- Mosaic Life Care, based in St. Joseph, Missouri , has ... of 58 clinics, located in 22 cities, and its flagship St. Joseph Medical Center. ... the delivery of health care to its patients, including the insurance, billing and collections ... ... Mosaic Life Care St. Joseph Medical Center ...
(Date:3/23/2017)... , Mar. 23, 2017 Research and ... Devices Market: Analysis By Procedure, Replacement Procedure By Technique, Repair Procedure ... offering. ... Heart Valve Devices Market is forecasted to grow at a CAGR ... valve devices is driven by rising aging population, growth in population ...
(Date:3/23/2017)... 23, 2017 Executive ... through extensive primary research (inputs from industry experts, ... to present the analysis of global heart valve ... and Repair); Replacement Procedure By Technique (Mechanical, Bioprosthetic, ... (Surgical Devices, Balloon Valvuloplasty, Transcatheter Mitral Valve Repair ...
Breaking Medicine Technology: