Proposed Medicaid expansion to cover uninsured

Marilyn Matthews of Havertown has been jobless since 2006 but being healthy and childless has disqualified her for Medicaid.

A central component of Democratic efforts to expand health coverage for uninsured Americans is to extend Medicaid eligibility to poor adults without children, a group of people who have never before had access to the joint federal-state health program.

Since its creation in the 1960s, Medicaid has been largely limited to the elderly, disabled, pregnant women and poor children. But with childless adults comprising the majority of uninsured people, some states, including Pennsylvania and New Jersey have tried to expanded access to public health programs to fill the gap.

Now, President Obama's proposal and the Senate health bill would extend Medicaid eligibility to everyone with incomes up to 133 percent of the federal poverty level - $14,404 for a single person.

The nonpartisan Congressional Budget Office estimated that the expansion of Medicaid would extend health coverage to about 15 million people. It would, however, come with a substantial price tag. The CBO estimated cost: $374 billion over ten years. Alternatively, it would cost an estimated $425 billion to extend Medicaid eligibility to 150 percent of the federal poverty level, as the House health bill does.

In today's Health & Science section, Rick Schmitt of Kaiser Health News reports on the "radical shift in thinking" over Medicaid eligibility and how both sides of the health debate are ambivalent about the approach with conservative critics lowering the volume of the "anti-welfare rhetoric" and supporters of expanded health covered questioning whether Medicaid expansion is the way to go.

One key question is whether doctors - many of whom decline to take Medicaid beneficiaries because of low payment rates - would accept the influx of newly covered adults as patients. Check out the full story in The Inquirer.

The Congressional Budget Office estimates that both bills would cover roughly an additional 15 million people by 2019 at a cost of $374 billion for the Senate bill and $425 billion for the House measure.