New Health Insurance Exchanges, Enhanced Medicaid To Improve Healthcare Access

A study, published in the May issue of the journal Health Affairs, on the fractured state of the 2.6 trillion US Healthcare systems says, access to health care deteriorated for US adults aged 19 to 64 between 2000 and 2010, even among those with private health insurance.

This age group, according to data from the US Census, would account for around 195 million people and has been targeted for expanded health coverage under the 2010 Patient Protection and Affordable Care Act.

The legislation would extend affordable health coverage to more than 32 million uninsured Americans from 2014. This would be done by making, partly subsidized, health-insurance markets that were monitored and regulated by the state and by increasing the joint federal-state Medicaid program for the poor.

The Supreme Court is going to rule on this next month and the verdict is expected to have far reaching consequences. The U.S. Department of Health and Human Services says access to care and use of healthcare services has declined in recent years, mainly because the number of the unemployed and the uninsured grew owing to the recession.

Children healthcare did not face the same level of erosion and remained protected as there were concentrated efforts to enhance their health coverage. Researchers have said, that following the basis of how child healthcare escaped erosion, similarly adults would benefit from reforms that “counter higher costs for the privately insured, raise Medicaid payments to providers and shore up the social safety net.”

Researchers wrote, “If the key coverage provisions in the (law) are ruled unconstitutional or repealed, projections indicate that the numbers of uninsured people will grow. Given what we have observed over the past decade, we would be likely to see further deterioration in access to care for all adults — insured and uninsured alike.”

Republicans are using it as a campaign tool and hope that it will be one of the rungs on the ladder that will help propel them into the White House. They have pledged to rescind it, if they come into power.

The success of the healthcare law, including Medicaid, depends largely on how state governments, most of which are opposed to it, react to it.

Experts opine that “To encourage high participation in the expanded Medicaid program, states will need to offer comprehensive coverage of needed benefits, provide community-based outreach and consider more dramatic changes to their enrollment processes, such as automatically enrolling people in Medicaid based on their participation in other public programs,” the experts said.

To create better access and to eradicate existing racial and ethnic disparities in access to healthcare, it is important that new insurance exchanges should be created and Medicaid should be expanded. There are more uninsured amongst Hispanics and Blacks than there are amongst Whites. However, the state’s response is paramount to know what will be the degree of improvement.

The researchers said, “Coverage gains among Hispanics will probably depend on adoption of strategies that address language and related barriers to enrollment and retention in California and Texas, where almost half of Hispanics live.”