Spotlight Exclusives

An Opportunity and a Challenge: Providing Health Coverage for the First Time to Millions of Childless Low-Income Adults

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Prior to passage of health care reform legislation, most low-income adults without dependent children were not covered through Medicaid.  But starting in 2014, 17.1 million adults, representing 37 percent of the uninsured in this country, will become eligible under the new rules, which expand Medicaid coverage to nearly all low-income individuals up to 133 percent of the poverty level ($14,404 for an individual in 2009).


This change will mark a significant step forward in guaranteeing health coverage for all Americans.  It will also involve one the largest enrollment efforts in Medicaid history. According to the new report released by the Kaiser Family Foundation۪s Commission on Medicaid and the Uninsured, the influx of potential new Medicaid recipients will present both a tremendous opportunity and a major challenge.

The report, Expanding Medicaid to Low-Income Childless Adults Under Health Reform: Key Lessons From State Experiences, draws on the past experiences of states covering low-income adults to provide a framework for approaching the upcoming expansion efforts. Among the key findings:

·         Medicaid faces challenges in reaching and enrolling low-income childless adults due to issues such as limited connection to public programs, fluctuating incomes, and language and cultural barriers.

·         Innovative outreach through unemployment offices, job training programs, shelters, community colleges and employee organizations, along with targeted messaging, will help reach low-income childless adults who have been historically excluded from Medicaid.

·         Because childless adults have been denied health care through Medicaid for so long, many states have discovered that this group has greater health needs than expected. Therefore, more must be learned about their specific health needs as well as how to best deliver and manage their care

While all these factors present a challenge, they also constitute a rare opportunity to refine our Medicaid outreach system and help millions of low-income adults gain access to health insurance.  It is a challenge our country must prepare now to meet.

Posted by Eliza


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