One of the things that the health insurance exchanges will do is inform people if they are eligible for Medicaid. Officials in some states are concerned that this awareness will result in people “crawling out of the woodwork” and flooding the Medicaid program. This viewpoint is disturbing in many ways.
The Supreme Court ruled that the Affordable Care Act was constitutional, and would stand. The Justices also made a ruling regarding Medicaid.
They decided that it was acceptable for Congress to offer a state funding that would be used by the state to expand its Medicaid program. If the state accepts the funding, then the state actually has to use it for what it was intended for – to expand the Medicaid program. If the state chooses to refuse the funding, then the state does not have to expand its Medicaid program. In this situation, Congress is not allowed to reduce the usual funding that the state would normally receive for Medicaid.
It has become clear that some states have refused to put together a state health insurance exchange. Texas is a very vocal example. Governor Perry has also refused to expand the Texas Medicaid program. It is obvious that this is Governor Perry’s way to protest the Affordable Care Act.
It turns out that many state Governors have other concerns about the Affordable Care Act. One of the things that the exchanges will do is clearly inform people who are eligible for the state’s Medicaid program that they are able to receive Medicaid. The exchanges will also make it really easy for this group of people to sign up for Medicaid.
The purpose of the exchanges is to help people to find affordable health insurance, and Medicaid is an affordable health insurance program for people who are below a certain income level. Right now, there are plenty of people, in every state, who should be receiving Medicaid, but who are not getting it. Some are unaware that they can be covered by Medicaid. Others have been thwarted by the difficult process that one must currently go through to sign up for it.
There are some state Governors and legislators who are living in fear of the “woodwork effect”. Everyone will be required to have health insurance coverage in 2014. People will use the exchanges to find affordable insurance. Many people who are currently uninsured will be able to sign up for the Medicaid program that the state should have already signed them up for. There is fear that this will overwhelm the Medicaid system.
I find this disturbing. When you use a phrase like “coming out of the woodwork”, it implies an infestation, (most likely one of insects or parasites). It bothers me that some legislators equate people who are uninsured with pests that need to be irradiated.
It also seems to me that if certain states did what they were supposed to be doing in the past – making sure eligible citizens received Medicaid – that there would be less uninsured people today. It seems like the Governors of the states who are most strongly resisting a Medicaid expansion are the ones that failed to properly do their job, and now are afraid to have to correct their mistakes.
Images by JMacPherson on Flickr