Hospitals and other healthcare stakeholders will be closely watching how many of the 23 holdout states, if any, decide to expand Medicaid eligibility in 2014. Extending Medicaid to adults with incomes up to 138% of the federal poverty level is one of the most important and politically contentious mechanisms for expanding insurance coverage under the Patient Protection and Affordable Care Act.
In addition, policymakers and patient-care advocates will be scrutinizing the continuing rollout of Medicaid managed care, which increasingly covers elderly and disabled beneficiaries who previously were not included. Part of that expansion grows out of a federal initiative mandated by the ACA to coordinate benefits and services for the 9 million low-income and disabled Americans who are eligible for both Medicaid and Medicare.