Presumptive Medicaid Eligibility – Will Presumptive ObamaCare Eligibility Be Next?


Presumptive ObamaCare Eligibility  may be next – hospitals enrolling patients at point of service. Imagine lying in the ER, signing up for insurance while filing a claim then suffering the indignation of having to pay a co-pay.  – Homer G. Farnsworth, M.D.

Your crazy! I’m not signing up unless the hospital pays the premium and the co-pays! Let the insurance company pay my claim! – Mary Freeloader

Presumptive Medicaid Eligibility’ by Chris Fleming

A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation examines the concept of presumptive eligibility in Medicaid. For many years, states were permitted to allow “qualified entities” (which includes hospitals) to presumptively enroll children and pregnant women into the Medicaid program. Once temporarily enrolled, families were encouraged to complete the formal enrollment process.

As of last January, 33 states exercised this option, which anecdotal evidence has shown increases the likelihood of eventual enrollment. The Affordable Care Act (ACA) expands the role of hospitals in screening patients and in temporarily enrolling those who meet the appropriate income standard. As ACA implementation advances, presumptive eligibility seems likely to be an important tool in expediting access to coverage for uninsured low-income Americans.

Health Policy Briefs are aimed at policy makers, congressional staffers, and others needing short, jargon-free explanations of health policy basics. The briefs, which are reviewed by experts in the field, include competing arguments on policy proposals and the relevant research supporting each perspective.

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