Medicaid is Expanding. Will you Qualify for Healthcare Coverage?

In 2020, the state of Nebraska, among other states, can look forward to a Medicaid expansion. What does this mean exactly? Well, Medicaid determines healthcare insurance eligibility based upon income levels associated with aging, disability, and poverty. It is a program meant to provide healthcare to people who could not otherwise afford it.

WHY THE CHANGE

Over time, the cost of living and what it means for people and the overall healthcare system gets reevaluated. The result recently is an expansion of the number of people who will be eligible for Medicaid healthcare coverage, coming August 1, 2020.

WHAT TO EXPECT

Expanding Medicaid seems like a win-win: more patients paying for services and more people with healthcare coverage. Those are both things we need in healthcare. However, it is not so simple and we often fail to see the ramifications of this type of expansion. What exactly are the positive and negative impacts, if any, and to whom? Let’s consider:

• Individual Patients
• Medical Providers
• Healthcare Clinics
• Hospitals and Emergency Rooms

MEDICAID EXPANSION IMPACTS ON INDIVIDUALS, CLINICS, HOSPITALS, AND PROVIDERS

The Medicaid expansion impact is different depending on the type of providers, patient demographics, and facilities – everyone will have slightly different impacts. However, growth will be a necessity moving forward.

INDIVIDUAL PATIENTS

People who qualify for Medicaid must currently be at 100% or below the poverty line, which in 2020 is an income of $16,910 for a family of two, or $30,170 for a family of five. With this expansion, the family of two can now earn $23,336 and the family of five can earn $41,635 and still qualify for Medicaid coverage.

MEDICAL PROVIDERS

Providers in low-income areas typically want patients with insurance because they will get paid for services provided that would otherwise be a loss with their sliding scale patients, and they will see more patients in general, who might not seek care without coverage. They may also not have the capacity for an increase in patients.

Providers who did not have sliding scale fees may now have more patients seeking care as well, as these patients will go to their provider, rather than the emergency room or opt for no care. We can predict a greater need for healthcare providers in general than we are currently experiencing.

HEALTHCARE CLINICS

Healthcare facilities that provide sliding scale fees for patients without healthcare coverage will likely have more patients who qualify for coverage and will soon be able to pay with the expansion – increasing revenue. However, these clinics may not have the capacity to take on these added patients and visits.

HOSPITALS AND EMERGENCY ROOMS

It would seem that paying patients will only benefit hospitals, but they also may have trouble with capacity, as more people will seek care that may not have in the past.

HOW TO APPLY

To enroll August 1, 2020, go online at HealthCare.gov or use the call center at 1-800-318-2596. You can also enroll online at ACCESSNebraska, or print a paper application from their website

WHO IS ELIGIBLE TO APPLY

Adults up to age 64 with income up to 138 percent of the poverty level (see the chart above) will be eligible for Medicaid.

PATIENTS OF BLUESTEM HEALTH

We’ve got you covered. We have Patient Support Services ready to help you determine eligibility, and we are excited about this expansion and what it means for your health. We want nothing more than for our patients to get the care they need without the burden of cost. As an organization, we continually grow and set goals to meet the needs of our growing patient base and we will continue to strive to meet the needs of our patient population.

HOW CAN BLUESTEM HELP?

If you have questions or need help with Medicaid Expansion Enrollment, please visit https://www.bluestemlincoln.com/contact-us or call 402-476-1455 and ask to speak with Patient Support Services about applying for Medicaid coverage with the recent expansion.

Click to read more about Nebraska’s Medicaid program and preventive care.