Study: Medicaid expansion will help lower out-of-pocket costs

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The study found major variations in the out-of-pocket burden poor people face in each state. Accepting the Medicaid expansion could help narrow those gaps, the report said.

"States with a larger share of low-income residents currently facing high medical spending burden levels may benefit most," said Kyle Caswell, a researcher at The Urban Institute and the study's lead author. "State officials can alleviate this burden by expanding Medicaid eligibility, which will enable people with limited resources to access health care at no or very low cost.”

Roughly half of the country's governors have said they want to participate in the Medicaid expansion, although some state legislatures have been less eager to sign on.

The Affordable Care Act (ACA) expands Medicaid eligibility to people with incomes at or below 138 percent of the federal poverty line. The Supreme Court's 2012 healthcare ruling made the expansion optional for states.

The federal government initially covers the entire cost of the expansion, but some Republican governors have refused to participate.

States that opt in, though, are taking advantage of an important tool to ease the healthcare burden on their poorest residents, according to the study.

"The ACA’s Medicaid expansions can potentially play an important role in expanding access to comprehensive medical care at no or very limited cost to low-income individuals … States that participate in the expansions have an opportunity to significantly decrease financial burdens for a high-need segment of their population," the report said.