The Affordable Care Act promises to extend the reach of health care coverage to many people who don’t have it now. Critics say it will do that at a huge cost in both money and individual liberty. But the mandate in the law for nearly everyone to buy health insurance has been upheld by the U-S Supreme Court and that requirement will take effect in 2014. The question facing Utah and the rest of country is how to implement the provisions that are maintained by the states.
The State Department of Health is moving forward on an overhaul of the Medicaid system despite opposition. Utah’s new managed care contracts are designed to save the state money and are slated to go into effect in January, but some health advocates say the proposed contracts do not ensure quality care for patients. And the state’s Inspector General says the contracts do not ensure proper oversight of Medicaid funds. KUER’s Andrea Smardon reports.
The U.S. Supreme Court's ruling on the Affordable Care Act put the decision of whether or not to expand Medicaid coverage up to each individual state. Medicaid eligibility can be a very complex issue but at its most basic level is based upon household income as a percentage of the Federal Poverty Level. For a family of four the federal poverty level is set at $23,050. You can see the current income limits based on the FPL in the graph below.
After the Supreme Court decision on the Affordable Care Act, states are faced with a decision on whether to expand Medicaid eligibility. Utah remains undecided. In the last story in our series, The Future of Medicaid in Utah, we look at how the decision affects all of us as taxpayers and healthcare consumers.
Utah lawmakers will decide in their next legislative session whether or not to expand Medicaid under the guidelines outlined in the Affordable Care Act. Unlike Medicare, which is a federal program for the elderly, Medicaid is a partnership with states that provides a healthcare safety net for those in need.
But qualifying for Medicaid is not automatic. The income and eligibility requirements are complex and the state employs dozens of people to help make those determinations.
Since the Supreme Court ruling on the Affordable Care Act, governors in four states have declared they will not expand Medicaid. Utah is currently undecided. State lawmakers met Tuesday to review the Supreme Court’s decision - and Utah’s options.
Republican Representative James Dunnigan of Taylorsville is chair of the state’s Health System Reform Task Force. He says the expansion of Medicaid is a big policy decision for Utah, and lawmakers are still gathering information.