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Medicaid Expansion: A Closer Look At Vulnerable Populations And State Coverage Opportunities
Health Affairs Blog, Shannon McMahon, 09/11/2012
Since the Supreme Court’s verdict on NFIB v. Sebelius in late June, considerable national attention has converged around the question of whether or not states will opt to expand Medicaid coverage for adults with incomes below 138 percent of the federal poverty level (FPL). The argument for states to move forward – or not – has centered largely on political and budget considerations, many of which revolve around the implications of reduced Disproportionate Share Hospital payments under the ACA. There has been relatively little public focus on the opportunity for states to use the Medicaid expansion to increase access to coverage for vulnerable populations. Vulnerable populations among the newly eligible include people who are homeless, many with serious and persistent mental illness; low-income veterans; and jail-involved individuals. Each of these often overlapping groups pose unique coverage challenges for states and their care delivery partners.