Medicaid Expansion is going to hurt seniors

[lynn63]

Currently in most states, seniors that are poor qualify for Medicaid as their secondary insurance to Medicare. If states chose to expand Medicaid those seniors will eventually be unable to get this needed coverage.

The population that could not qualify for Medicaid before 2014 still most will not qualify. If you do not earn any money, you won't qualify. They must be disabled, blind, children, or women who are pregnant and require prenatal care.

The Medicaid expansion allows all those adults that work part time, or work for minimum wage with 2 kids. There are some other benefits but really do not apply to the majority of that population.

60% of women work minimum wage jobs that have kids and this would be a big burden on the States and also on the person who has to be insured. The costs for the <133% ppl will still cost them 650 a year in premiums and a 2,000 deductible.

Everyone above the 300 to 400 PPL are people that have low paying jobs and are struggling to pay living costs. These are healthy young people who seldom need healthcare. The ACA knows this and this is the 30 million that the insurance companies are waiting for for pure profit.

 

[Greenbeard]

The population that could not qualify for Medicaid before 2014 still most will not qualify. If you do not earn any money, you won't qualify. They must be disabled, blind, children, or women who are pregnant and require prenatal care.

I think you've missed the point of the expansion. Yes, Medicaid has historically been a program that limited eligibility to certain categories of people; being poor alone wasn't sufficient to qualify. Being sufficiently poor and falling into one of those categories was.

The point of the expansion was that a new catch-all category was to be added to Medicaid, effectively making everyone below a certain income threshold eligible for the program. The new category is right there in black and white in the Social Security Act:

(VIII) beginning January 1, 2014, who are under 65 years of age, not pregnant, not entitled to, or enrolled for, benefits under part A of subchapter XVIII, or enrolled for benefits under part B of subchapter XVIII, and are not described in a previous subclause of this clause, and whose income (as determined under subsection (e)(14)) does not exceed 133 percent of the poverty line (as defined in section 1397jj (c)(5) of this title) applicable to a family of the size involved, subject to subsection (k);

In other words, the new category is "everybody else who wasn't already eligible, provided their income is below 133% FPL."

This is in fact why the Supreme Court found the Medicaid expansion unconstitutional. By creating a new category that encompasses everyone (below the specified income level), SCOTUS said that Congress effectively changed the nature of the program. A categorical program that must then add a category covering everyone isn't a categorical program anymore. Meaning Congress went too far in tying money for the "old" Medicaid program to participation in the "new" program, i.e. the Medicaid expansion.

So say the robed elders:

But the expansion accomplishes a shift in kind, not merely degree. The original program was designed to cover medical services for particular categories of vulnerable individuals. Under the Affordable Care Act, Medicaid is transformed into a program to meet the health care needs of the entire nonelderly population with income below 133 percent of the poverty level. A State could hardly anticipate that Congress&#8217;s reservation of the right to &#8220;alter&#8221; or &#8220;amend&#8221; the Medicaid program included the power to transform it so dramatically. The Medicaid expansion thus violates the Constitution by threatening States with the loss of their existing Medicaid funding if they decline to comply with the expansion.

The remedy is that the expansion is now optional. But those states that choose to go forth with the expansion do in fact have to expand coverage to everyone in the state below 133% FPL, regardless of whether they fall into one of the pre-existing eligibility categories.