Those who herald the Affordable Care Act (ACA, or “Obamacare”) as a success continue to be vexed by the six million or so citizens who are eligible for Medicaid but simply don’t sign up for it. Perhaps that should not be surprising, however, given that most people eligible for Medicaid are exempt from having to pay a penalty for being uninsured—one of the ACA’s prime incentives for individuals to get insured—and those eligible can sign up for Medicaid coverage at any time. Further, Medicaid patients can receive retroactive coverage for up to three months after receiving care. This could ultimately prove very costly for the healthcare system; uninsured, Medicaid-eligible people have been shown less likely to access regular preventive care, leaving them at greater risk for illness requiring costly hospital care instead of low-cost prescriptions or office-based procedures that would have been sufficient with earlier diagnosis. Promoting services commonly offered in the urgent care setting in areas high in Medicaid-eligible populations could ultimately prove beneficial for cash-paying patients and fruitful for insurers.

Medicaid Holdouts Continue to Confound ACA Proponents
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