CHCS - Center for Health Care Strategies

Improving the quality and cost-effectiveness of publicly financed health care

Covering Low-Income Childless Adults in Medicaid: Experiences from Selected States

Type:
Policy & Issue Briefs
Author:
Stephen A. Somers and Allison Hamblin, Center for Health Care Strategies; James M. Verdier and Vivian L.H. Byrd, Mathematica Policy Research
Published:
August 2010
Funder:
Robert Wood Johnson Foundation, UnitedHealthcare, and Aetna

Under health reform, 16-20 million beneficiaries will be newly eligible to enroll in Medicaid. To prepare for this new population, it is critical that Medicaid stakeholders develop a better understanding of who these individuals are and what their care needs will be. 

In Covering Low-Income Childless Adults in Medicaid: Experiences from Selected States, CHCS and its partners from Mathematica Policy Research examine experiences from 10 states with existing programs for low-income childless adults to shed light on the potential expansion population. Key findings include:

  • The expansion population will include many relatively healthy beneficiaries as well as a significant number of individuals with multiple comorbidities and high levels of likely service utilization.
  • Individuals who are below 50 percent of the federal poverty level will have the highest levels of morbidity, including high rates of mental illness and substance abuse.
  • Different participation rates among population subsets will drive Medicaid costs; those with more complex needs are likely to enroll first.
  • Costs for the expansion population on average are likely to be greater than costs for parents currently enrolled in Medicaid, but less than costs for adults with disabilities.
  • States will need partners with experience caring for people with multiple chronic conditions.
  • Medicaid must work closely with health insurance exchanges to ensure continuity of care for beneficiaries crossing income thresholds.

To help guide states in preparing for the expansion population, the brief also outlines considerations for delivery system design and suggests opportunities for further analysis. By using state-based data, this brief complements expansion population projections that are based on national data sets.

 

Copyright © 2014 Center for Health Care Strategies, Inc.
200 American Metro Blvd., Suite 119 Hamilton, NJ 08619
tel. 609 528 8400    fax. 609 586 3679