Medicaid Changes: Millions Could Lose Coverage Under Proposed Bill

A Republican-backed bill, awaiting Senate consideration after passing the house by a narrow margin, proposes critically important alterations to Medicaid and the Affordable Care Act (ACA).These Medicaid changes could result in up to 10.9 million Americans losing health insurance, according to Congressional Budget Office (CBO) estimates.

Key Provisions of the Proposed Healthcare Bill

The “One Big Beautiful Bill Act,” supported by former President Donald Trump, aims to modify several aspects of the healthcare system. Key provisions include:

• Adding work requirements for some Medicaid recipients.
• Mandating more frequent eligibility verification.
• Restricting immigrant access to health insurance.
• Modifying subsidies for marketplace coverage.

These changes are projected to disproportionately affect low-income individuals and those with disabilities,potentially reversing gains made under the ACA in reducing the uninsured rate.

Did You Know? The Affordable Care Act, enacted in 2010, substantially expanded Medicaid eligibility and provided subsidies for individuals to purchase health insurance on the marketplace, leading to a historic drop in the uninsured rate.

Impact on Medicaid Recipients

the proposed legislation introduces work requirements, obligating some individuals aged 19 to 64 to work or engage in other qualifying activities for at least 80 hours per month to maintain Medicaid coverage. States would also have the option to require proof of compliance from previous months.

For individuals with disabilities or those with caregiving responsibilities, meeting these requirements could pose significant challenges. Even without the new requirements, some Medicaid recipients already struggle to navigate the eligibility verification process.

Furthermore, the bill mandates states to conduct eligibility checks every six months for individuals who qualified for Medicaid under the expansion, potentially leading to coverage lapses due to paperwork errors or administrative hurdles.

colorado’s Potential Coverage Losses

The health policy nonprofit KFF estimates that between 120,000 and 190,000 people in Colorado could lose their insurance over the next decade due to the bill, primarily through Medicaid disenrollment. Colorado’s own estimates suggest that up to 110,000 people could leave the individual marketplace as the bill would make insurance harder to get and more expensive.

As of April, approximately 1.2 million Coloradans were enrolled in Medicaid, and about 296,000 purchased insurance through the individual marketplace.

Pro tip: Stay informed about changes to Medicaid eligibility requirements in your state. Contact your local Department of Health and Human Services for assistance with enrollment and renewal processes.

Changes to the Individual Marketplace

The bill also proposes changes to the individual marketplace, including preventing low-income individuals from enrolling outside of the open enrollment period and requiring more stringent verification processes for tax credit subsidies. This could effectively end automatic re-enrollment and shorten the enrollment window to 45 days.

additionally, the bill could lead to higher premiums and out-of-pocket costs for marketplace plans, potentially making insurance unaffordable for many individuals.

Expert Perspectives

Sara Collins, a senior scholar at the Commonwealth Fund, suggests that the intention behind the bill is to create friction in the system of obtaining and maintaining insurance through Medicaid and the individual marketplace. She believes that many people will lose coverage due to difficulties navigating the system or as insurance becomes too expensive.

Adam Fox, deputy director of the Colorado Consumer Health Initiative, believes that the estimates of coverage losses are low, particularly in states like Colorado, where county human services offices handle Medicaid eligibility. He argues that increased paperwork and processing requirements will create more opportunities for people to get lost in the shuffle.

Projected National Impact

The CBO estimates that approximately 10.9 million people nationwide would become uninsured as a result of the bill, with about 72% losing Medicaid coverage and the remainder losing insurance purchased through the individual marketplace. An additional 5.1 million could lose individual coverage if enhanced subsidies expire this year.

these changes represent a significant shift in the healthcare landscape, potentially returning the insurance system to a state similar to that before the ACA’s passage in 2010.

Senate Prospects

The bill’s future in the Senate remains uncertain, with both fiscal conservatives and moderate Republicans expressing concerns. The debate over these proposed Medicaid changes is expected to be intense, with significant implications for millions of Americans.

What are the potential long-term consequences of these proposed Medicaid changes on public health?

How can individuals prepare for potential changes to their healthcare coverage?

Disclaimer: This article provides general data about proposed healthcare legislation and should not be considered as legal or financial advice. Consult with a qualified professional for personalized guidance.

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