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Medicaid's Costly 'Revolving Door'

When Medicaid becomes a revolving door, it ends up both harming patients and increasing costs, a study by two George Washington University researchers finds.


"Even short gaps in coverage can lead to delay or avoidance of needed care," says Leighton Ku, the director of the Center for Health Policy Research at George Washington University's School of Public Health and Health Services. "This can result in significant increases in hospitalizations for chronic diseases like diabetes, asthma and mental disorders. These costly interruptions can arise from something as simple as a change of address."

The study was sponsored by the Association of Community Affiliated Plans, which represents 58 nonprofit "safety net" health plans in 24 states. It's lobbying for a guarantee that would allow Medicaid beneficiaries to stay in the program for 12 months or more. This, the oragnization says, would be a solution "to the phenomenon of 'churn,' where otherwise-eligible beneficiaries are disenrolled and reenrolled in the program owing to paperwork issues or small and often temporary changes in income."

Related: Implications of Expanding Medicaid for Uninsured Low-Income Midlife Adults

As the Hill reports: "According to the study, a Medicaid beneficiary enrolled consistently for 12 months pays $333 in medical bills per month, on average. Patients enrolled for six months paid $469, and those enrolled for one month paid $625. "

Past research by Ku has described Medicaid as a "leaky sieve" that leaves seniors and other low-income beneficiaries without coverage because of bureaucratic snafus and often temporary changes in income, leading to expensive hospitalizations and other health consequences.

Want to know how much Medicaid "churn" there is your state? Look here.


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