The Ethical Healthpreneur

Introduction The Affordable Care Act (ACA) offers a lifeline for millions of Americans who have lost their Medicaid coverage this year. As states resume their regular eligibility checks and remove people from their Medicaid rolls, many of them may be unaware of their options to get subsidized health insurance through the ACA marketplaces. The HealthCare.gov sign-up period starting this week could be a chance to enroll them and prevent gaps in their care. The Medicaid unwinding The COVID-19 pandemic triggered a federal policy that prevented states from disenrolling anyone from Medicaid, unless they moved out of state or voluntarily withdrew.  This policy, known as the  maintenance of effort  (MOE) requirement, was meant to ensure continuous coverage for low-income people during the public health emergency. However, the MOE requirement ended on March 31, 2023, and states began to review their Medicaid caseloads and remove those who no longer qualified or failed to respond to renewal noti

"Medicare Advantage is the future of Medicare." This is how Seema Verma, the former administrator of the Centers for Medicare & Medicaid Services (CMS), described the private health plans that offer an alternative to the traditional fee-for-service Medicare program. However, not everyone shares this optimistic view, especially some hospitals and doctors who are increasingly terminating their contracts with Medicare Advantage plans over payment disputes. Understanding Medicare Advantage Plans Medicare Advantage plans, also known as Part C, are offered by private insurance companies that contract with CMS to provide Medicare benefits to enrollees. These plans often include extra benefits, such as vision, dental, and prescription drug coverage, and may have lower premiums and out-of-pocket costs than Original Medicare. However, they also have more restrictions on which providers and facilities enrollees can use, and may require prior authorization or referrals for certain s

Medicaid expansion   is one of the most controversial and impactful aspects of the Affordable Care Act (ACA). It allows states to extend health insurance coverage to low-income adults who would otherwise be uninsured or underinsured.   ·         As of October 2023, 41 states and the District of Columbia have adopted Medicaid expansion, while 10 states have not.   Why does Medicaid expansion matter for young adults? ·         According to the U.S. Census Bureau, young adults aged 19 to 34 have the highest uninsured rate among all age groups, at 14.9% in 2020 .   ·         Many young adults face barriers to accessing affordable and quality health care, such as low wages, unstable employment, high student debt, and lack of parental support. ·         Without health insurance, they are more likely to delay or forego preventive care, experience financial hardship due to medical bills, and suffer from poor health outcomes.   Medicaid expansion can offer a lifeline to millions of young adults