Health Center News

Tightened Medicaid Eligibility Tied with Delayed Care

In a study  released by the New England Journal of Medicine, researchers from Brigham and Women’s Hospital and the Harvard school of Public Health found that tightened Medicaid eligibility rules leads to reduced access to primary care doctors and, more importantly, more people delaying care. The researchers studied data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) survey that focused on six counties with varied health care management strategies. A significant pattern emerged in the prevalence of delayed care, ranging from 6.5 percent in Norfolk, Massachusetts, to 40.6 percent in Hidalgo, Texas.

The study found that Southern states, like Texas and Florida, are particularly hard hit with tight Medicaid rules and reduced access to care. Communities with a higher rate of delayed care were also more likely to be Hispanic, low income, and have a high prevalence of chronic disease. According to Kaiser about 25 percent of Texas residents are uninsured and in parts of Florida, New Mexico, Texas, Louisiana and California 36 to 40 percent of the non-elderly population would benefit from Medicaid expansion.

In many states coalitions of consumer and interest groups, hospitals, doctors, patients, and Community Health Center leaders are making the case to state leaders and governors that expanding the Medicaid program would provide more people with coverage and decrease delays in care that result in a financial burden on the health system and taxpayers.

To underscore that message NACHC has developed a Medicaid Expansion Calculator. The calculator was designed from a prototype provided by Rick Shinn from the Virginia Community Health Care Association. It allows health centers and primary care associations to enter their own specific data and make the business case by computing the additional revenue Medicaid expansion would provide if uninsured patients gained coverage.

NACHC is already planning a second version of the calculator so feel free to give us your feedback. For more information on this study visit the New England Journal of Medicine here.