As Congress continues to debate repealing of part or all of the Affordable Care Act, state lawmakers are beginning to think of a contingency plan.
Aside from the millions of people who’ve gained health insurance under Obamacare, many others are now covered by states that expanded eligibility for Medicaid.
Delaware chose to do so in 2014, signing up about 10,000 new people. But if Congress repeals the law, the state would have to cover $120 million in extra insurance costs should policymakers choose to offer the same level of coverage.
Joint Finance Committee co-chair, Sen. Harris McDowell (D-Wilmington North), says it may be premature to consider a plan B, but notes the options available are all grim.
“We know that if [Congress goes] ahead and [repeals] the ACA it’ll have severe, adverse effects on our budget and a whole lot of individuals’ healthcare,” McDowell said.
Projected growth in Medicaid spending is modest compared to years past, at $13.3 million for fiscal year 2018. In the current year, Delaware will pay about $760 million for its share of the program.
In an effort to reduce future costs, his fellow co-chair, Rep. Melanie George Smith (D-Bear), said Delaware could look into requiring adults on Medicaid to take steps toward better long-term health in exchange for added benefits.
Such a change would need approval from the Centers for Medicare and Medicaid Services.
Other states, like Ohio and Kentucky, have discussed charging premiums or forcing enrollees to look for work while covered by the program. Federal officials blocked Ohio's proposal, while they continue to review Kentucky's.
