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Law Will Shift Demographics For Medicaid Toward Healthier Group, Study Finds

By Ankita Rao

September 9th, 2013, 5:34 PM

The health law is expected to change the face of Medicaid – literally.

As part of the federal overhaul, some states have opted to expand in January this state-federal health insurance program for low income people to include Americans who earn as much as 138 percent of the federal poverty line (just under $16,000 for an individual in 2013). As a result, the new enrollees will include more white, male and healthy individuals than those eligible before the Affordable Care Act expansion, according to a study in the Annals of Family Medicine.

Using statistics from the National Health and Nutrition Examination Survey, the authors found that the group of newly eligible individuals is:

  • About 36 years old on average, compared with about 39 years old for the current enrollees.
  • Approximately 59 percent non-Hispanic white, compared with about 50 percent in the existing group.
  • Equally split between males and females, compared with about 67 percent female and 33 percent male in the current Medicaid population.
  • More likely to smoke and drink, but also more likely to have lower rates of obesity and diabetes.

The University of Michigan researchers hope the information will help inform health providers and policy makers who are gearing up to plan for the more than 13 million adults potentially eligible for Medicaid after Jan. 1.

“It’s really a game changer,” said Dr. Tammy Chang, a lead author of the report. “A lot of providers think of Medicaid as people who take a lot of time to see, who use a lot of resources.”

She said the stereotypes of the Medicaid population – high-risk, chronically ill – affect the way doctors and health care systems view treatment for these beneficiaries since the costs of those patients is often higher. A shift in the demographics could also mean a greater focus on prevention and family care, rather than chronic disease.

In addition, the study could help inform health providers who are worried about how they will be paid by Medicaid patients, said Sara Rosenbaum, a health law professor at the George Washington University School of Public Health, who is not affiliated with the study.

“I think many have made assumptions about the population,” she said. “But the [health law] takes a group of people and gives them coverage – it should be good news for the providers.”

On the flip side, Rosenbaum said there is also the question of enrolling those who are currently eligible for the program, but are lost in the system and remain uninsured. This phenomenon will mostly likely still be a sicker population, she said.

While the study is based on national, not state data, Chang said the information could encourage more access to Medicaid since it could actually lower health costs through preventive care for a younger population.

Rosenbaum, too, is hopeful that the new information will give hesitant states more incentive to pursue the health law’s Medicaid expansion, since some have cited the burden of high health costs as a concern.

“It’s about the need for good family care, routine care,” she said. “One would hope that encourages states to open up their programs.”

8 Responses to “Law Will Shift Demographics For Medicaid Toward Healthier Group, Study Finds”

  1. greg says:

    “Law Will Shift Demographics For Medicaid Toward Healthier Group, Study Finds”

    ???

    That’s outrageous!

    Heaven help us! As a Republican, we certainly don’t want to see healthier people have access to Medicaid, right? As a Republican, I think that would be shockingly excessive, right? As a Republican, I think we certainly don’t want to run out of people to exclude from the privilege of having access to healthcare services, huh? As Republican, wouldn’t that be just awful?

  2. greg says:

    As a Republican, allowing more people to enroll in Medicaid would simply ruin our “Us versus Them” policy! As a demographic, poor people and elderly people are the boogieman, right? Republicans always need a boogieman, right?

  3. I think there is nothing wrong if the law will shift considering demographics involving healthier groups. Prevention is greater than treating something that is not curable anymore. I will definitely support this move. :-D

  4. Karin says:

    The fact is medicaid patients get to go to any clinic or dr. that they want. This is a benefit that has privlages over the people who work and are offered their health programs, the people who put the money into the system to help people that do not have health coverage or cannot afford it. It is wrong for people that we are helping to have greater privilidge. All people should be covered yes, but at what cost to the people that supply the funds for this program.
    Instead of having people so wrapped up in the helping everyone as much as possible we need to look at other avenues besides offering every means available to those that are less privilaged. Face it those that are less priviledged are no longer less privilaged are they?
    A need to stop riding the train to ruins. There are better ways to run healthcare than offering all options to those who don’t work and there are better ways to run healthcare than the way that coding is mandated by the same system that is failing. Administrative costs has always had priority over the healthcare itself and the cost is astronomical. Talk about complicating things, its no different than our tax system yet we depend on this system that’s plagued with failures to make a susccessful outcome. Stupid.

  5. Sam says:

    Another post coming from someone that does not have a clue about how the Affordable Care Act really works. Geez! Let me guess. You are a Republican, right?

  6. Karin says:

    Not Republican so get over yourself. I most certainly know well about the affordable healthcare act which the name in itself is quite the opposite. I’m guessing you don’t know how the program works Geez.

  7. Matt says:

    Actually, it is quite common for physicians to choose not to provide care to Medicaid patients, typically because of the low reimbursement rates for Medicaid and the greater difficulty of treating Medicaid patients due to their lower health status, lower health literacy and treatment adherence, etc. In fact, this is most common in lower income areas of the country where there are the highest concentrations of Medicaid-eligible individuals.

    While the ACA will increase Medicaid reimbursements, this is not expected to make a large impact nationwide in the number of physicians accepting these patients. Perhaps this trend towards a slightly healthier Medicaid population will encourage some physicians to start seeing these people.

    Uninformed sweeping generalizations and political trash talk do nothing to advance conversation.

  8. Sue says:

    “Uninformed sweeping generalizations and political trash talk do nothing to advance conversation.”

    Two points…

    1. Tell that to the Republicans that have been trying to torpedo the ACA for the past three years strictly for political reasons.

    2. So I guess we must all consider you as informed?

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