A new Health Affairs study:
- Pre-ObamaCare, approximately half of low-income adults might have experienced a change of circumstances that caused churn between Medicaid and private coverage each year.
- Higher-income states and states that had more generous Medicaid eligibility criteria for nonelderly adults before the ACA experienced more churning.
- Under ObamaCare, more than 40 percent of adults likely to enroll in Medicaid or subsidized exchange coverage would experience a change in eligibility within twelve months.
Why is this important? Because people who are eligible for Medicaid are not allowed to get private, subsidized insurance in the exchange and vice versa.
The authors’ recommendation:
Policy options for states to reduce the frequency and impact of coverage changes include adopting twelve-month continuous eligibility for adults in Medicaid, creating a Basic Health Program, using Medicaid funds to subsidize Marketplace coverage for low-income adults, and encouraging the same health insurers to offer plans in Medicaid and the Marketplaces.
A better solution? Universal, refundable tax credits that allow every American, at any income level, to choose and purchase individual, portable, health insurance with continuous coverage. It’s described here.