COVID-19

States scrambling with Medicaid enrollments climbing

Erika Beras Nov 30, 2020
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Medical workers walk outside of a special coronavirus intake area at a hospital in Brooklyn earlier this year. Spencer Platt/Getty Images
COVID-19

States scrambling with Medicaid enrollments climbing

Erika Beras Nov 30, 2020
Heard on:
Medical workers walk outside of a special coronavirus intake area at a hospital in Brooklyn earlier this year. Spencer Platt/Getty Images
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As this pandemic stretches on and on, one health care plan that’s been gaining enrollees all year is Medicaid.

The federal and state program helps with medical costs for children, disabled people and those with low-incomes. This year’s increase in Medicaid enrollments may mean financial trouble for states. Some may need to start looking for ways to cut Medicaid costs without cutting the Medicaid program.

As millions of people have lost their jobs in this pandemic, many have also lost their health insurance.

“Medicaid has really been a first responder in the COVID-19 pandemic, both from a health perspective and an economic perspective,” said Joan Alker, executive director of the Center for Children and Families at Georgetown University.

As of July, some 4 million more people enrolled in Medicaid than were on the rolls in February, and that number keep growing. With all those new enrollees comes added expense.

For most states, Medicaid makes up around one-third of the state budget.

With less income tax coming in, less sales revenue and a slew of unexpected pandemic expenses, states are strapped.

“Governors are working on putting together budgets for the upcoming 2022 fiscal year, which begins July 1. And they will have to assume that fiscal relief is not available,” said Robin Rudowitz with the Kaiser Family Foundation.

The federal government typically matches state expenditures 50/50. But for people who got Medicaid through the Affordable Care Act expansion, the government covers 90%. States also got extra federal money for Medicaid through the CARES Act in the spring.

Sara Rosenbaum, a health law and policy professor at George Washington University, said states are looking for any place they can trim.

“Probably the No. 1 thing states are strategizing around is cutting provider payments or deferring provider payments in order to free up money,” she said. Or eliminating health benefits, like dental or vision.

James Nash of the National Governors Association said if states can’t make more trims in Medicaid, other vital services could be cut.

“We’re talking about K-12 and higher education. We’re talking about corrections and public safety,” he said.

So states are doing some hard math.

COVID-19 Economy FAQs

Millions of Americans are unemployed, but businesses say they are having trouble hiring. Why?

This economic crisis is unusual compared to traditional recessions, according to Daniel Zhao, senior economist with Glassdoor. “Many workers are still sitting out of the labor force because of health concerns or child care needs, and that makes it tough to find workers regardless of what you’re doing with wages or benefits,” Zhao said. “An extra dollar an hour isn’t going to make a cashier with preexisting conditions feel that it’s safe to return to work.” This can be seen in the restaurant industry: Some workers have quit or are reluctant to apply because of COVID-19 concerns, low pay, meager benefits and the stress that comes with a fast-paced, demanding job. Restaurants have been willing to offer signing bonuses and temporary wage increases. One McDonald’s is even paying people $50 just to interview.

Could waiving patents increase the global supply of COVID-19 vaccines?

India and South Africa have introduced a proposal to temporarily suspend patents on COVID-19 vaccines. Backers of the plan say it would increase the supply of vaccines around the world by allowing more countries to produce them. Skeptics say it’s not that simple. There’s now enough supply in the U.S that any adult who wants a shot should be able to get one soon. That reality is years away for most other countries. More than 100 countries have backed the proposal to temporarily waive COVID-19 vaccine patents. The U.S isn’t one of them, but the White House has said it’s considering the idea.

Can businesses deny you entry if you don’t have a vaccine passport?

As more Americans get vaccinated against COVID-19 and the economy begins reopening, some businesses are requiring proof of vaccination to enter their premises. The concept of a vaccine passport has raised ethical questions about data privacy and potential discrimination against the unvaccinated. However, legal experts say businesses have the right to deny entrance to those who can’t show proof.

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