Colorado’s governor is absolutely correct to embrace the coming 2014 expansion of the joint federal- and state-funded Medicaid coverage to include individuals earning less than about $15,000 and families earning less than about $31,000 annually. That is estimated to benefit about 160,000 Coloradans.
Universal coverage is the cornerstone of the federal Patient Protection and Affordable Care Act, and this Medicaid expansion is the method to include adults with limited incomes. Children in low-income families are already covered by Medicaid.
The reasons are proven. Those who have insurance are much more likely to take advantage of preventive care and to receive the coordinated care that results in an early diagnosis, important in increasing the likelihood of successful treatment, and thus in reducing health-care costs. In addition, because Medicaid will cover many unpaid health-care bills, there will be a steep reduction in the amount of unreimbursed care that burdens hospitals. Unreimbursed care, along with cost-shifting, adds to what those with insurance, or cash, have to pay.
Healthy Coloradans, whatever their wage scale, are more likely to be productive and to lead satisfying lives.
At the same time, health care is extraordinarily expensive in this country. Colorado will have to be alert to do all it can to hold down Medicaid costs to manage its share of the cost of expansion which begins in 2017.
For the first three years, the federal government will pay 100 percent of the expanded coverage. In 2017, Colorado will be obligated for 5 percent, increasing to 10 percent by 2020. Estimates can be elusive, but Colorado’s share in 2012 could be $100 million.
Gov. John Hickenlooper has said savings through delivery efficiencies, plus existing provider fees, will be sufficient to cover the state’s share. He has promised that no general fund revenues will be required.
In Colorado’s favor, in the effort to hold down costs, is the progress the state has made in developing the insurance exchanges that are included in the Affordable Health Care Act and which go into effect in 2014. The exchanges will allow employers and individuals to have a much wider selection in insurance coverage than they do now, and because of state-set templates comparison shopping will be much easier. That will make it possible to better match needs and coverage and to sort through premium amounts. Those tasks are daunting, now, for small businesses and individuals.
Colorado’s exchange, which will give the state insights into efficient health-care delivery, will play a role in how to best spend Medicaid funding.
Colorado is considered to be in the top half dozen, or fewer, of states in making progress in shaping their exchanges.
We look forward to the day when all Coloradans have health insurance. That should be the starting point in making basic levels of proper health care, at reasonable cost, available to everyone.