How to Expand Medicaid Eligibility

Health care coverage is an emotional issue for citizens throughout the world. America covers its senior citizens with the Medicare program. Medicaid is relegated to low-income families. Each state administers its own Medicaid program. It will take a nationwide approach, however, to expand Medicaid.

Instructions

Expanding Medicaid

• 1

  Eliminate confusing regulations. The Estate Rule under Medicaid gives states the right to potentially seize the home of a beneficiary in the event his care exceeds a certain amount. This kind of rule is a red flag for potential beneficiaries who would otherwise participate in the program. A home doesn't automatically equate to wealth, and should not be used as a tool to recoup costs by the state.

• 2

  Expand coverage to single individuals who are not disabled and have no children. Medicaid is currently only available to low-income families or disabled adults. This leaves a large number of single adults with no children among the uninsured. Many of them work, but employer plans may not cover them because of their part-time status. This step alone would lead to the largest increase in the Medicaid program and the largest decrease in low-income working uninsured.

• 3

  Make Medicaid eligibility standard across the nation. Each state currently determines eligibility based on a percentage of the Federal Poverty Level (FPL). While one state allows eligibility at 200 percent of FPL, another state may decide Medicaid eligibility at 350 percent of FPL. Standardizing Medicaid eligibility nationwide will allow easier access to Medicaid programs from one state to the next. A beneficiary in one state would not fear a potential loss of coverage resulting from looking for better job opportunities, and possibly higher income, in another state.

• 4

  Motivate providers with competitive reimbursement rates. Medicaid expansion fails if providers opt not to participate in the program. Doctors, therapists, nurses and all other skilled professionals must receive a rate that is competitive with Medicare and commercial providers. Seeking participation from providers is key to any expansion of the Medicaid program. More providers will adopt the program when they are receiving competitive reimbursements.

• 5

  Communicate eligibility criteria better to those currently eligible. Currently, only 60 to 70 percent of those eligible for the Medicaid program actually participate in it. Expanding the program is as simple as a marketing plan to reach potential beneficiaries. Social network pages, print media and television spots aimed at potential beneficiaries will lead to an expansion of Medicaid.

• 6

  Prepare for regional inequalities. There is a greater percentage of low-income individuals in the South and the West. Therefore, the need for additional funds in these areas once Medicaid is expanded will not be surprising. The Federal funds used to match state Medicaid dollars will equal the percentage of low-income individuals in specific regions. Thus, there will be more dollars available for the South and West.