Less than a quarter of the states have taken necessary steps to create health insurance marketplaces, a key feature of Obamacare, while 43 states have made new cuts to Medicaid. Taken together, the two trends highlight the challenges facing healthcare reform at the state level, The Washington Post reported.
States must have exchanges in place by 2014. Seven states have adopted laws establishing the exchanges that are designed to make it easier for people to compare health plans and create enough customers to slow rising prices. Those states are California, Colorado, Hawaii, Maryland, Vermont, Washington, and West Virginia, the Post reported.
Two other states, North Dakota and Virginia, have passed laws saying they will form exchanges. An additional seven states have accepted federal money to set up the exchanges but have not passed legislation.
However, nearly a dozen states have defeated or allowed to expire measures that would have set up exchanges and another 13 have not even considered such proposals. Louisiana has told the federal government it will not set up an insurance marketplace, the Post reported.
Health and Human Services’ Paul Dioguardi
told the Post he was confident states that have not acted will do so.
Also starting in 2014, the federal law will expand Medicaid to Americans with incomes higher than most states have allowed until now, putting further strain on a system already struggling as a result of the poor economy, the Post reported.
In Maryland, Medicaid enrollment has grown by 11 percent in the past year to nearly 920,000 participants. The General Assembly has just ordered cuts to the program’s $7 billion budget totaling about 1 percent, according to the Post.
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