One major aspect of the Affordable Care Act (ACA) is affordability. President Obama has stated that people unable to afford the insurance would be eligible for either subsidies or Medicaid assistance.
I recently attended a meeting in Olympia where this subject was brought up. These figures are the best estimates that the state government is using in making plans for the introduction of the ACA.
Of the approximately 1 million Washingtonians who are currently uninsured, officials are planning on expanding the Medicaid program by 400,000.
The U.S. Census Bureau estimates the entire population of the state at 6.8 million, so the 400,000 additional folks on Medicaid are approximately 6 percent of the entire state population.
Washington is comprised of 39 counties; of those counties 18 of them have a population of less than 50,000. Those counties are: Adams (population 18,950), Asotin (21,650), Columbia (4,100), Douglas (38,650), Ferry (7,600), Garfield (2,250), Jefferson (30,050), Kittitas (41,300), Klickitat (20,500), Lincoln (10,600), Okanogan (41,200), Pacific (20,900), Pend Oreille (13,000), San Juan (15,900), Skamania (11,150), Stevens (43,600), Wahkiakum (4,000) and Whitman (44,800).
Now, if you add up the total population of those 18 counties, can you guess what it comes to? I won’t make you dig out your adding machines I shall tell you — 390,200.
So, the expansion of Medicaid in Washington is akin to placing every man, woman and child in those 18 counties onto government assistance.
But wait, that’s not all … Let’s take that one step further, those 18 counties account for 46 percent of the entire state in size of area.
Let’s now talk about money. Medicaid is a jointly funded program where the costs are shared equally between the federal and state governments.
However, the federal government is paying 100 percent of the cost of this massive expansion of Medicaid for three years from 2014-2016.
Starting in 2017 a portion of the cost share will be passed back to be the states’ responsibility. The states share will be 5 percent in 2017 and that will increase to 10 percent by 2020.
If a conservative cost per enrollee is $300 per month, that is $120 million per month or close to $1.5 billion per year. Wait, I forgot — $1.5 billion is written out as $1,500,000,000.00, or $1,500 million.
One item I am unsure about and have not been able to find out to my 100-percent satisfaction is the role the federal government in paying for the expansion of state government in administering these plans and benefits.
For example, the state of Washington can’t suddenly increase the workload of the state employees who deal with Medicaid by 400,000 new clients. I assume the federal government is assisting in the costs associated with the implementation of the new bureaucracies to deal with this new influx to the system.
I actually had to resort to an old-fashioned dictionary to spell the word “bureaucracy” and found the following as one of the definitions of the word. “An administrative system in which the need to follow complex procedures impedes effective action.”
I found an interesting video clip on the State of Washington website that discusses the expansion of Medicaid. To me is appears as if the speaker is excited about the challenges of such an expansion and I am sure many a career will be enhanced by the greater size and scope of their employment opportunities. Find the video at www.hca.wa.gov/hcr/me.
As I learn more about the ACA and how it will be implemented in the state, I shall be sure to include it in future columns.
Next week I shall be outlining all the plans and benefit changes for the fast approaching Annual Enrollment Period for Medicare Advantage as well as Medicare Part D plans in Clallam County.
The open season starts on Oct. 15 and will run through Dec. 7, with all changes to be effective Jan. 1, 2013.
Phil Castell is an independent insurance agent in Sequim. He can be reached at 683-9284 or PhilCastell@msn.com.
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