How Obamacare may morph into Medicaid

(The Conversation is an independent and nonprofit source of news, analysis and commentary from academic experts.)

J.B. Silvers, Case Western Reserve University

(THE CONVERSATION) The slow-motion consideration by Congress and the president to change the Affordable Care Act is likely to produce surprising results. The insurance market does not go into suspended animation while Washington debates.

In any event, the delay and uncertainty, along with predicted reactions of insurers, will guarantee that only low-income working people who are eligible for subsidies will be covered by exchange plans.

Ironically, these are akin to the folks that Medicaid covers now but at a higher level of income than what would qualify for coverage normally. Thus, the result of the impending meltdown of the exchanges may be effectively an extension of Medicaid-type coverage to a greater number of working poor than we have now.

By destroying the initial thrust of the ACA exchanges to give affordable options to everyone regardless of income or health status, we may effectively wind up just extending our current and revamped Medicaid programs for the poor to those with somewhat higher incomes – an ironic result for those bent on reducing Medicaid. But this would come at the cost of returning the individual markets for everyone else to their former dysfunctional state.

And this all may happen by default while the debate goes on rather than by design.

Is this the way to do health policy?

This article was originally published on The Conversation. Read the original article here: http://theconversation.com/how-obamacare-may-morph-into-medicaid-79072.

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