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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