The Next Stages in the Healthcare Reform

All those who have an interest in the New York Medicaid system will be watching closely in coming months as more aspects of the landmark Affordable Care Act (Obamacare) are unrolled. While it has been several years since the law was passed–and recently upheld from legal challenge by the U.S. Supreme Court–many provisions in the legislation were only scheduled to be enrolled over several years. The passage of the bill did not change anything overnight, and it is only over the long-term that the full impact of the provisions will be felt by community members, including many who use the Medicaid program.

A recent report from the Brookings Institute on the coming changes compared the situation to a hurricane. The high-profile political battle over its passage and legal wrangling over its constitutionality was the first half of the storm. We are now in the “eye” with little discussion or interest in the mater. However, that will soon change. As more aspects of the program are unrolled the political battle may intensify yet again.

So what can we expect in the future?

Essentially, in October of 2013 individuals can begin enrolling in the new healthcare insurance exchanges created as part of the law. Qualification for the exchange comes in several ways, including via Medicaid. The report explains how the new law provides a way for states to expand Medicaid coverage so that individuals qualify even if they have income at 138% of the federal poverty level. Yet, states are not required to expand in this way. Residents in states not expanding coverage will only qualify if their income is at or below 100% of the poverty level.

States are now working furiously to put the administrative infrastructure in place to handle that implementation date. Each state is in charge of its own implementation, though some have done nothing and will rely on the federal rules for everything. Also, because nothing on this scale has ever been attempted before, even the states working on the new system are not 100% sure if they are doing everything they need to do to avoid problems. Undoubtedly kinks will need to be worked out once things get underway.

At the end of the day there is no denying that the Affordable Care Act is a complex and confusing public-private venture. As we begin 2013, local residents should keep their ears open to details about how the changes are affecting the New York Medicaid system. As always, it may be prudent to visit with elder law estate planning attorneys to ensure any changes are reflected in your long-term care plans.