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The promise and pitfalls of expanded Medicaid

Under the Affordable Care Act, many states have made it easier to get Medicaid, a move that will affect cities, experts say.

The U.S. Conference of Mayors is meeting this week in Washington, and among the many things on the agenda is the rollout of Obamacare.

Under the Affordable Care Act, many states have made it easier to get Medicaid, a move that will affect cities, experts say.

“It kind of casts a wider net of eligibility,” says Tom Carroll, a healthcare services analyst with Stifel Nicolaus. And that has boosted enrollment. One in five Americans is enrolled in Medicaid.

“It’s gone up by a significant amount already, and it’s just going to keep going up with each month that goes by,” says Mark Duggan, a professor of health care management at the Wharton School of the University of Pennsylvania. 

According to Michael Sparer, chair of the health policy and management program at Columbia University’s Mailman School of Public Health, this could have an effect on the economics of health care at the local level. Cities and local governments provide health care to the uninsured, “and they do this through public hospitals, public health clinics, and other safety net provider offices,” he says.

It will help cities and local governments, the more eligible Americans enroll in Medicaid.

“Either because they get additional reimbursement, as the uninsured become insured, or because their burden is reduced because perhaps formerly uninsured folks start to go to private sector providers,” Sparer explains.

But, it’s not all good news. There will still be Americans who aren’t insured, and because of other changes to Medicaid and Medicare, reimbursements are getting smaller.

About the author

David Gura is a reporter for Marketplace, based in the Washington, D.C. bureau.
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