Tuesday, July 20, 2010

A correction concerning the ACA’s Medicaid coverage expansion

Yesterday I wrote a first post on the constitutionality of the ACA's amendments to Medicaid, and specifically whether the Act's new requirements unconstitutionally commandeer the states. As part of that post, I identified the requirement that states must provide a "benchmark" benefits package to all the newly eligible Medicaid beneficiaries (persons who would not have been eligible under the state's criteria as of the enactment of the ACA but who become eligible due to the coverage expansion to all persons under 65 years of age up to 133 percent of the federal poverty level).

Thanks to a helpful e-mail this morning from Mark Regan, Legal Director for the Disability Law Center of Alaska, I now see that my characterization was misleading (or just plain wrong). The ACA's requirement that states provide the "benchmark" benefits package (the minimum that must be offered in any package sold through a state exchange) is only an expansion in the sense that it forbids states from offering the newly eligible a largely hollowed-out, catastrophic-type benefits package. It is actually a reduction if we compare the "benchmark" package to what was minimally required under Medicaid prior to the ACA, and what must still be offered going forward to those persons who are eligible for Medicaid under the pre-ACA criteria (i.e., the non-newly eligible).

(My wife actually suggested this point to me a few days ago, but, as usual, I was not paying as careful attention as I should have.)

Sorry for any confusion.