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Medicaid Expansion, Payer Oversight Seen as Vital to Healthcare Reform

Christopher Cheney, for HealthLeaders Media, March 25, 2014

Medicaid expansion, regulation of insurers, and oversight of private insurance plans are key factors in the national healthcare reform effort, a Commonwealth Fund report suggests.

"In states choosing not to expand Medicaid, more than 15 million underinsured and uninsured people have incomes below poverty—earning less than $23,550 a year for a family of four," the Commonwealth Fund report released this morning says. "Unless their states expand Medicaid, there will be no new coverage options—either Medicaid or premium assistance—available to them."

On a teleconference call to present the findings Monday, the lead author of the report said the resister states are taking a high-risk gamble. "There's a lot at stake when we exclude those under 65 from having insurance," said Commonwealth Fund Senior VP Cathy Schoen. "It's a very valued good. It's something people want and they want better health."

The research sets state-by-state baseline data for the number of uninsured and underinsured across the country before the introduction of healthcare reforms under the Patient Protection and Affordable Care Act.

Low-income individuals were considered underinsured if they had health insurance but spent 5 percent or more of their income on medical costs. People in higher income brackets were considered underinsured if they spent 10 percent or more of their income on medical costs.

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