​Why Medicaid Expansion Matters to Floridians Already on Medicare

What is Medicaid Expansion? Under the Affordable Care Act (ACA), Medicaid was expanded to provide health insurance coverage to low-income uninsured adults aged 19-64.  The Supreme Court ruled that each state should decide whether or not to expand Medicaid.
 
How is Medicaid Expansion Funded? If Florida decides to expand Medicaid, the federal government pays 90% of the cost to cover the newly insured individuals and Florida pays 10%.  In comparison, under Florida’s current Medicaid program, the federal government pays 62% of costs and Florida 38%.
            
What is the status of Medicaid expansion in Florida? Florida is one of only 12 states that has refused increased federal funding to cover low-income uninsured adults. 
 
How many uninsured Floridians, including older Floridians, would benefit from Medicaid expansion? Over 1.5 million low income Floridians would be eligible for Medicaid if/when Florida joins the 38 expansion states, including an estimated 400,000 Floridians aged 50 to 64.[1]
 
What happens to older uninsured Floridians? By the time they reach age 65, older uninsured Floridians may have gone years without doctor visits, preventive care, and the early diagnosis and treatment of health problems.  Thus, conditions that could have been treated at a lower cost, will be much more expensive when they are ultimately covered by Medicare.  Take the example of a 65 year-old with Stage 3 colon cancer who has been without insurance for 10 years.  By the time he enrolls in a Florida Medicare plan, he needs surgery, radiation and chemotherapy.  These costly treatments (now covered by his Medicare plan) likely could have been avoided with a routine colonoscopy, but because he was uninsured and low-income he avoided the procedure.
 
How does not expanding Medicaid impact Medicare? Without Medicaid expansion, Medicare enrollees will likely see a rise in out-of-pocket care costs and/or fewer participating healthcare providers. 
 
Why is it more expensive? The cost of all insurance programs, including Medicare, is increased by the number of uninsured.  Insurance program costs also increase when covered individuals have high-cost healthcare needs.  When system costs rise, additional revenue must be generated (for instance, by increasing co-pays), and/or costs must be cut (for instance, by lowering provider reimbursement, discouraging provider participation.) 
 
What is the bottom line? Medicaid expansion not only helps protect your Medicare, it also helps older adults continue working, brings more money into the state, supports hospitals, improves health outcomes for seniors and saves lives.[2]


[1] A June 25, 2020 study by the Kaiser Family Foundation found that over 1.5 million Floridians, including those who experienced pandemic-related insurance loss, are eligible for Medicaid expansion.  See, Rachel Garfield, et al., “How Many Uninsured Adults Could Be Reached If All States Expanded Medicaid?”.  We derived our estimate of the number of older uninsured (400,000) from a Center on Budget and Policy Priorities (CBPP) study based on pre-pandemic data. The CBPP found that 184,000 of 693,000 (27%) Medicaid-eligible adults were aged 50-64. See, Jesse Cross-Call, et al., States that Have Expanded Medicaid are Better Positioned to Address COVID-19 and Recession.  Using that proportion, we determined that approximately 400,000 of the 1.5 million currently eligible for Medicaid expansion are older Floridians. 
 
[2]  A study published by the National Bureau of Economic Research, see S.Miller et al., and summarized by CBPPfound that as a result of the state’s decision not to expand Medicaid, 2,776 Floridians ages 55-64 died between 2014 and 2017.
 
 
                                                                               www.floridahealthjustice.org
 
For more information, contact Miriam Harmatz, harmatz@floridahealthjustice.org, Matt Childers, childers@floridahealthjustice.org.,  or Alison Yager, yager@floridahealthjustice.org 

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