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Reform Update: More than 100,000 early retirees now qualify for Medicaid under ACA expansion, GAO says

By Virgil Dickson
Posted: June 3, 2014 - 4:15 pm ET

Obamacare is allowing many Americans to retire early and claim Social Security benefits at age 62 without shouldering exorbitant healthcare costs until they can get Medicare, according to the U.S. Government Accountability Office (PDF).

About a million early claimers did not have Medicaid or employer-sponsored health insurance before the coverage provisions of the Patient Protection and Affordable Care Act kicked in this year. Of those, 14% may be newly eligible for Medicaid in the 25 states (and the District of Columbia) that expanded the program under the law. Another 58% could be eligible for tax credits toward purchasing coverage through the new insurance exchanges.

But the agency found that 10% of these early claimers lived in states that did not expand Medicaid and had incomes that were below the federal poverty level—too low to qualify for exchange subsidies.

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Elsewhere, Medicaid promises access to insurance with no premiums and no or nominal cost-sharing, the report notes. Across the 26 states expansion states, the percentage of these early claimers eligible for Medicaid expansion ranges from 17% in Delaware and Massachusetts to 60% in the District of Columbia.

Experts encourage workers to stay employed until the formal U.S. retirement age of 66 to avoid a reduction in monthly Social Security benefits. But the ability to get healthcare will be crucial for workers who have no choice, according to the National Committee to Preserve Social Security and Medicare.

“The people helped by this are people who have been forced out a job at age 62 or 63,”said Webster Phillips, a senior legislative representative for the advocacy organization. “Once these people have lost their jobs, it's very difficult for them to find another one.”

Many of them, though, may forgo Medicaid because of the stigma the program holds, particularly among older Americans, said Linda Riddell, health policy analyst at Health Economy, a consulting firm that specializes in health data analysis and employee health costs.

And experts generally agree that the new low-cost coverage options are unlikely to result in a flood of people checking out of the workforce early. In February, the Congressional Budget Office observed that the law could have a positive impact on the dynamic known as job lock, in which people stay in jobs only because they need the health benefits.

“Expanded Medicaid eligibility under the ACA will, on balance, reduce incentives to work,” the CBO said in the report (PDF). “(However,) that effect has a relatively modest influence on total labor supply.”

Hospitals already see upside in states that expanded Medicaid

Hospitals in states that chose to expand Medicaid under the Affordable Care Act saw significantly more Medicaid patients and a related reduction in self-pay and charity-care cases, according to a new national study released by the Colorado Hospital Association. For those states that did not expand, the amount of self-pay and charity-care cases remained steady.

The study used data from 465 hospitals in 30 states from the first quarter of 2014. Data was gathered from Jan. 1 to March 31. The researches estimate a 29% increase in Medicaid patient volume and parallel 25% and 30% drops in self-pay and charity care respectively in expansion states.

“These findings not only affirm that more people are finding healthcare coverage who didn't have it before, but also that it is having a positive impact by reducing the levels of uncompensated care at hospitals, which could further efforts to reduce healthcare costs,” Steven Summer, the association's president and CEO, said in a statement.

Faith leaders admonish states resisting Medicaid expansion

The 24 states that have yet to expand Medicaid under the Affordable Care Act are causing a “moral crisis” by leaving millions of low-income Americans uninsured, faith leaders say, according to the Associated Baptist Press.

“History has not been kind to governors who stand in front of schoolhouse doors because the children are not the right kind of children, and history will not be kind to governors who stand in front of hospital doors and clinics because people who are trying to get in are deemed politically dispensable,” Rev. Raphael Warnock, senior pastor of Ebenezer Baptist Church in Atlanta, said during a conference call with reporters on May 29.

Also participating in the call was Catholic Health Association President and CEO Sister Carol Keehan, a persistent ally of the law. “This is not a simple political agenda like more roads or less roads,” Keehan said. “This is people's lives at stake.”

Follow Virgil Dickson on Twitter: @MHvdickson

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