With the recent conclusion of the presidential debates and the 2012 U.S. presidential election fast approaching, there has been a great amount of interest about the state of healthcare and the direction it will take after November 6, 2012. These pressing topics are intimately linked with the institution of the Patient Protection and Affordable Care Act (PPACA), commonly known as Obamacare, which was passed into law in 2010.1,2,3
The first of three blogs in the “What’s in Store” series, I want to clarify and explain issues that were mentioned throughout this year’s presidential debates and how they affect youth access and availability to healthcare right now and in the near future. The first topic I will focus on is Medicaid and the stances both Barack Obama and Mitt Romney have on this subject.
Medicaid was a health program instituted by the United States government to support low-income families and individuals with particular disabilities. The program is jointly funded by the federal government and states, and managed on a case-to-case basis by the states.5 Since June 2007, before the start of the recession, an additional 10 million people enrolled in this social program, over half of whom were children. By June 2011, enrollment in Medicaid reached 52.6 million.4
With policy changes at both the state and federal level, enrollment in the program has been greatly affected. Effective April 2010, the PPACA provided states the opportunity to expand Medicaid coverage to include anyone 133 percent above the federal poverty line. A recent Supreme Court ruling confirmed this power given to the states, allowing them to opt-in or opt-out voluntarily.6
To understand the importance of Medicaid we must know its history, but also know what direction it may take in the coming years. This hinges upon the decisions made by the executive chief who will be chosen to lead our country in a little over a week. Here, I’ve outlined the positions the candidates have taken on Medicaid during the debates and the campaign.
Mitt Romney/Paul Ryan:
- supports giving capped federally-funded Medicaid block grants to states to spend on healthcare as they see fit.7,8
- opposes PPACA’s Medicaid expansion and plans to repeal the expansion if elected.
Barack Obama/Joe Biden:
- supports Medicaid expansion which could provide up to 17 million uninsured people with coverage. This would include childless young adults, who have historically been considered optional beneficiaries for the states.
- opposes federally-backed Medicaid block grants
One thing stands from these two positions: restructuring of the Medicaid program will occur in the next few years that will directly affect healthcare coverage of millions of young people in this country. Whether it is federally mandated or state run, it is for us to ultimately decide.