Medicaid Patients & The Affordable Care Act

As reported in Stateline, the daily news service of the Pew Charitable Trusts, the Affordable Care Act’s new requirements that insurers cover early detection and disease prevention services at no cost to the patient will not apply to those patients with Medicaid coverage.

The new preventive care guidelines are intended to improve overall health, reduce the number of preventable deaths and lower costs.

But some of the nation’s unhealthiest people — 25 million low-income adults who already qualify for Medicaid — aren’t likely to receive those benefits, because the requirements in the Affordable Care Act pertain only to private insurers, Medicare and Medicaid expansion programs.

In a report for Health Affairs, researchers Sara Wilensky and Elizabeth Gray of George Washington University in Washington, D.C. stated,

“The decision by Congress to leave existing Medicaid beneficiaries without the right to receive these preventive services means that many low-income people will continue to go without this care. . . If these services are so crucial to good health that coverage of them is required for so many others, why were people who are currently on Medicaid left off of health reform’s prevention bandwagon?”

For more information, see the full story from Stateline.

Coverage of preventative care under Medicaid varies from state to state.  According to the Maryland’s Medicaid covers some, but not all of the benefits of the new Affordable Care Act.  As described in the Department of Legislative Service’s Analysis of the FY2014 Maryland Executive Budget, however, Maryland’s Medicaid program already provides broad coverage and is planning to expand its membership under the Affordable Care Act, too.  Maryland Medicaid, which has an average monthly enrollment of 810.593, is planning to take advantage of the opportunity to expand Medicaid coverage to persons below 138% of the federal poverty level provided for in the federal Patient Protection and Affordable Care Act of 2010 (ACA). That expansion would occur January 1, 2014.

According to the Department of Legislative Service’s Analysis, Services provided under Medicaid in Maryland include federally mandated services such as nursing facility services; hospital inpatient and outpatient services; x-ray and laboratory services; early and periodic screening, diagnosis, and treatment services for children; family planning services; transportation services; physician care; federally qualified health center and rural health clinic services; and some nurse practitioner services. Maryland Medicaid also provides services which the federal government considers optional, including include vision care; podiatric care; pharmacy; medical supplies and equipment; intermediate-care facilities for the developmentally disabled; and institutional care for people over age 65 with mental diseases.

Courtesy of the Department of Legislative Services

For more information, see the Department of Legislative Service’s Analysis of the FY2014 Maryland Executive Budget.