The Affordable Care Act (ACA), widely known as Obamacare, allows for expanded Medicaid coverage for low-income Americans. So far, 36 states and the District of Columbia have adopted Medicaid expansion. In other states, the debate continues in numerous forms. Here’s some of the latest news on Medicaid expansion across the nation.
Kentucky Plans to Expand School-Based Health Services Under Medicaid Plan
Kentucky’s Cabinet for Health and Family Services is partnering with the Kentucky Department of Education to work toward amending the state’s Medicaid plan. This would expand physical and mental healthcare access to students in schools by allowing for the payment of qualifying services.
Under the proposed amendment, Kentucky school districts would be able to use federal Medicaid funding to expand access to school-based healthcare for students enrolled in Medicaid. This includes mental health services and health screenings. Currently, students can only receive these services if they are covered by an Individual Education Plan under Medicaid.
North Carolina Still in a Budget Stalemate Due to Medicaid Expansion Conflict
North Carolina has not had a state budget for most of July, with Gov. Roy Cooper facing off against Republican lawmakers over including Medicaid expansion in the budget.
Cooper wants to expand Medicaid across the state, but has expressed a willingness to consider a compromise. He has already vetoed one budget proposal, while Republicans try to build up enough votes to override it.
Fewer Psychiatrists Accepting Medicaid Patients
Despite greater coverage of mental health services under Medicaid expansion across the country, research shows that fewer psychiatrists are accepting Medicaid patients. Writing in JAMA Psychiatry, researchers report that the percentage of psychiatrists accepting Medicaid as payment declined from nearly 48 percent in 2010-2011 to 35 percent in 2014-2015.
The findings demonstrate that expanded coverage does not always lead to expanded access. This may also increase demand for other clinicians besides psychiatrists who accept Medicaid for behavioral health services.
Study coauthor Adam Wilk of Emory University suggests that a shortage of behavioral health providers may affect how existing providers do business. They may accept more patients with private insurance, or opt out of insurance completely. Lower fees, reimbursement delays, and administrative burdens make Medicaid less appealing for behavioral health clinicians.
Small Florida Counties Worried About Medicaid Expansion
Florida is one of the 14 states that have not yet expanded Medicaid coverage under ACA. A political committee called Florida Decides Healthcare, however, is working to put a constitutional amendment before Florida voters in 2020. The amendment would require the state to expand Medicaid to include adults under age 65 who earn less than 138 percent of the federal poverty level. Currently, that amounts to $29,435 for a family of three, or $17,276 for an individual.
Some of the state’s smaller counties, however, are worried about how the state will cover the additional cost. Many residents in poorer Florida counties are concerned that they could see higher tax bills under proposed Medicaid expansion.
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