Talking Points on Medicaid Expansion Maryland The Maryland chapter of the American College of Physicians applauds Governor O’Malley’s expressed intention to accept the unique opportunity that is now available to use federal dollars to expand Medicaid to everyone who has an income up to 133 percent of the federal poverty level (a technical adjustment brings the actual eligibility level up to 138 percent). The Maryland chapter represents 2,216 internal medicine specialists and medical student members who live, study, teach and practice in the state of Maryland. In a new report released by the chapter, we provide evidence indicating the extent to which Maryland will benefit by accepting federal dollars to extend Medicaid but also note the consequences to its residents if it does not. Extending Medicaid coverage will reduce the numbers of uninsured Marylanders by as much as 31 percent. This means that 224,000 adult Marylanders would be eligible for Medicaid coverage, including 167,000 who would be newly eligible under the health reform law. Thirteen percent of Marylanders – about 737,000 – were uninsured between 2009 and 2010. Medicaid expansion will help the “safety net” of physicians, hospitals, and academic medical centers better serve their low-income patients and reduce cost-shifting to the rest of us. Everyone in Maryland pays for the care that is provided on an uncompensated basis by hospitals and physicians, because those costs are shifted to the rest of us through higher premiums for our health insurance and higher taxes for government safety-net programs. The Medicaid expansion is especially crucial for hospitals, since the health care reform law cut the federal share of uncompensated care payments because lawmakers assumed the Medicaid expansion would heavily reduce the need for uncompensated care. In 2010, Maryland’s hospitals received over $76 million in Medicaid federal funds to help offset the cost of covering the uninsured. The state will benefit fiscally by accepting this unprecedented offer by the federal government to pay almost all of the costs of extending Medicaid to more Marylanders. Right now, the federal government pays about 50 percent of the cost for Marylanders enrolled in Medicaid; our state pays the other 50 percent. But starting in 2014, the federal government will pay 100 percent of the cost—yes, all of it!—for the first two years of extending Medicaid to all Marylanders with incomes below 138 percent of the federal poverty level. The state will gradually assume some responsibility for the Medicaid expansion, paying up to 10 percent of the cost in 2020 and beyond. It is estimated that about 142,000 uninsured adult Marylanders with incomes under 100 percent of the FPL would be denied coverage if Maryland chooses not to expand its Medicaid program.
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