5 Million Individuals Left in Healthcare Purgatory, Even as 6 Million Gain Medicaid Benefits in 2014

New Executive Briefing from HealthLeaders-InterStudy Anticipates That Many More States Will Move to Expand Medicaid

Oct 17, 2013, 12:03 ET from HealthLeaders-InterStudy

NASHVILLE, Tenn., Oct. 17, 2013 /PRNewswire/ -- HealthLeaders-InterStudy, the leading provider of managed care market intelligence, finds that the implications of rejecting Medicaid expansion under the Affordable Care Act (ACA) have prompted states that were originally against expansion to consider it. Months after the 2012 ruling from the U.S. Supreme Court made Medicaid expansion optional, fewer than half of the states will open to new enrollees as prescribed by the ACA. The court's ruling essentially means at least 5 million individuals living in states not expanding their programs are set to fall through the cracks, earning too much for Medicaid yet ineligible for federal subsidies on exchanges.

HealthLeaders-InterStudy expects this unintended consequence—essentially a healthcare purgatory for 5 million individuals—to be a short-term problem. The company's newest Executive Briefing, entitled "Arranging the Dominoes of Medicaid Expansion: 3 Key Takeaways for 2014 Strategy," describes how the implications of non-expansion are similar to dominoes falling in a predictable pattern, with the end result strongly motivating states to consider expansion.  The Briefing also pulls out the key takeaways that companies doing business in healthcare will need to consider in 2014.

"When the Supreme Court made Medicaid expansion voluntary for states, it in effect took the key component of the ACA—healthcare for the majority of Americans—and turned it upside down. While it was a given some states would line up to expand, it's the ones that haven't (such as Texas and Florida) which have knocked plans off course," explains Ric Gross, Sr. Analyst for HealthLeaders-InterStudy. "The landscape is rapidly changing, with no better examples than Arkansas and Michigan, both of which have displayed a willingness to expand Medicaid in vastly different ways.  Strategizing in the midst of a constantly evolving situation is challenging, to put it mildly—especially when the uncertainty impacts what will be one of the biggest business opportunities to ever affect U.S. healthcare."

HealthLeaders-InterStudy is offering an open webinar based on the newly released Executive Briefing, which will discuss how Medicaid expansion will affect every stakeholder in the healthcare landscape. This webinar will take place November 15th, 2013 at 2 pm Eastern and is open to media, government, payer, provider, PBM and Pharmaceutical executives. Register for the webinar here.

"As 2014 approaches, the implications of non-expansion have come into focus—the motivation for expanding Medicaid has become clear," adds Jane DuBose, Principal Director of Advisory Services at HealthLeaders-InterStudy. "However, there is still unsteadiness on the core ideas around how this will work—from concerns on physician supply to hospital funding."

Download the Executive Briefing at hl-isy.com/News-and-Events/White-Papers-and-Executive-Briefings

About HealthLeaders-InterStudy
HealthLeaders-InterStudy, a Decision Resources Group company, is the authoritative source for managed care data, analysis, and news. HealthLeaders-InterStudy is part of the Market Access Business Unit at Decision Resources Group which also includes Abacus International, Fingertip Formulary, Pinsonault, and PharmaStrat. Find out more at www.hl-isy.com.

About Decision Resources Group

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SOURCE HealthLeaders-InterStudy