By Lorie Hailey
LEXINGTON, Ky. (July 5, 2012) — Kentucky will benefit most from the expansion of Medicaid under the Affordable Care Act, according to an analysis by the Kaiser Commission on Medicaid and the Uninsured.
The healthcare law expands Medicaid to nearly all individuals under age 65 with incomes up to 133 percent of the federal poverty line, which will extend coverage to large numbers of the nation’s uninsured population, especially adults.
The number of uninsured adults earning less than 133 percent of the poverty line is expected to decrease in Kentucky by 57.1 percent — the highest in the nation — when the law implemented, according to the commission, which is the largest operating program of the Henry J. Kaiser Family Foundation in Washington, D.C.
The analysis found that Medicaid expansions will significantly increase coverage and reduce the number of uninsured; that the federal government will pay a very high share of new Medicaid costs in all states; and increases in state spending are small compared to increases in coverage and federal revenues and relative to what states would have spent if reform had not been enacted.
“There is a great deal of variation across states in terms of Medicaid coverage, the uninsured, state fiscal capacity, leadership and priorities,” the report said. “These variations make it impossible to know how each state individually will respond to the new health reform law.”
From 2014 to 2019, the commission reports that the federal government’s spending on Medicaid in Kentucky will be $11.8 billion, while the state will spend $515 million.
Medicaid enrollment nationwide is projected to increase by 15.9 million by 2019. This new coverage would result in a reduction of uninsured adults under 133 percent of poverty of 11.2 million, a 45 percent reduction in 2019.
States with more limited coverage and higher uninsured rates pre-reform (such as Texas) will see larger decreases in the uninsured compared to states with broader coverage and fewer uninsured pre-reform (such as Massachusetts), the report found.
Texas covers only working adults up to 26 percent of the poverty line, while in Massachusetts, everyone earning up to 133 percent of the poverty line — less than $15,000 for an individual — gets Medicaid.
“The impact of health reform will vary across states based on coverage levels in states today, state decisions about implementation and ultimately the number of individuals who sign up for coverage,” the report said. “It is impossible to know how individual states will respond, so this analysis looked at a range of participation assumptions that are applied uniformly across states, but in reality this will vary.”
“Some states may not aggressively implement health reform and therefore not see significant reductions in the uninsured, while other states will have higher levels of participation because of effective outreach and enrollment strategies and see greater reductions in the number of uninsured.”