Low-Income Adults: Can Medicaid Fill the Coverage Gap?

September 15, 2008

If you think that all poor Americans can get health coverage through Medicaid, think again. Except in a few states with federal waivers, adults must not only meet income and asset requirements, but must fit into a category of persons for which coverage is available.

If they are not parents of dependent children, disabled or elderly, they do not qualify for Medicaid coverage, no matter how poor. As a result, more than half of all low-income uninsured persons are adults who do not fit in current eligibility categories as defined by federal law.

A recent study estimates that almost 16 million uninsured adults age 18-64 have a chronic illness. Those without a way to pay for care have limited access to physicians; others use hospital emergency rooms when their untreated conditions become catastrophic. According to most analysts, unmanaged chronic illness is a source of inefficiency in our system and contributes to the high cost of care.

Can Medicaid be redesigned to cover non-categorical poor adults? What lessons can be learned from states’ efforts to cover the uninsured through Medicaid expansions? What are the challenges they have faced and are likely to face in the current economic climate? Can private insurance fill the void?

To address these and related questions, the Alliance for Health Reform and the AARP Public Policy Institute sponsored a September 15 briefing. A special focus of the briefing was a new AARP Public Policy Institute research report, Millions of Poor Americans Can’t Get Medicaid: What Can Be Done? Speakers will be: Stan Dorn of the Urban Institute and author of the new report; Barbara Coulter Edwards of Health Management Associates; Nina Owcharenko of the Heritage Foundation; and Gary Ferguson of American Viewpoint. Co-moderators will be Susan Reinhard, head of the Public Policy Institute, and Ed Howard of the Alliance.


Full Transcript (Adobe Acrobat PDF)

Speaker Presentations

Stan Dorn Presentation (PowerPoint)
Barbara Edwards Presentation (PowerPoint)
Gary Ferguson Presentation (PowerPoint)

Event Resources