Will Health Insurance Monopolies Come to an End? Expanding Medicaid

Aug 01, 13 Will Health Insurance Monopolies Come to an End? Expanding Medicaid

By Martha C. Rivera, Director of Strategy and Insights

Challenging health insurance monopolies is the real motive behind the ACA for some. In fact, states implementing Medicaid Expansion have already begun dismantling the monopolies. Most of the states who have announced that they are embracing this key component of the reform have already registered a fair number of specific health-plans. With that, a much richer spectrum of choices is made available to lowest-income consumers. For example, the most populous states show larger number of Medicaid health plans carriers, including New York (21) and California (9).

With the ACA aimed at providing health insurance coverage to the vast majority of Americans, Medicaid has expanded its eligibility criteria to include most individuals with incomes up to 138% FPL ($15,415 for an individual or $26,344 for a family of three in 2012) even if they are males or childless adults. Because of a Supreme Court decision issued in June 2012, states can decide whether or not they will implement the expansion.

Currently, the Medicaid expansion has no specific implementation deadline. As of July 1, 2013, a total of 21 states had reported that they will not move forward with it, 24 were already working on its implementation and six were still debating their decisions. However, only four of the states that chose not moving forward have passed legislative acts to prohibit it; most others seem to be going through a “let’s wait and see” moment.

“Multicultural populations are of pivotal importance on the Medicaid expansion, as the large majority of the uninsured who would qualify for the expansion are Hispanics, African Americans and Indians/Alaskans natives,” said George L. San Jose, president and chief creative officer at The San Jose Group. “Health care providers have begun to target multicultural audiences with culturally relevant communication platforms, but insurance carriers are still lagging way behind.”


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