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Many of Those Covered Under Medicaid Expansion Could Be Young People

By John Reichard, CQ HealthBeat Editor

August 10, 2012 -- Of the 15 million uninsured adults nationwide who could get Medicaid coverage under the health care law, slightly more than half are under the age of 35, according to a new study.

Most are white, and most are not living with dependent children, according to the analysis prepared by the Urban Institute with funding from the Robert Wood Johnson Foundation.

The health care overhaul provides federal funding to states to expand Medicaid coverage to adults with incomes up to 138 percent of the federal poverty level. The 15 million estimate assumes all states expand their Medicaid populations. However, the June 28 Supreme Court ruling on the health law (PL 111-148, PL 111-152) gives states the right to opt out of the expansion. It's not clear how many will do so.

"More than half of newly eligible uninsured adults—about 7.8 million—are under the age of 35," the study said. "Thirty-five percent are ages 35-54, while around 2 million are near-elderly, aged 55-64."

Coverage of the near-elderly group could not only increase their access to needed care but also reduce their costs to Medicare once they become eligible for that program, the study said. "Other research suggests that lack of coverage before reaching Medicare eligibility at age 65 is associated with higher Medicare expenditures," the study noted.

Fifty-three percent of those who could gain Medicaid coverage are male. A total of 4.6 million uninsured women in their childbearing years—ages 19 to 44 according to the study—could become eligible.

"This has the potential to lead to better health in women who are or who become mothers, to increased spacing between births, and to improved birth outcomes and health of newborns," the study said.

Fifty-five percent of the uninsured who could gain Medicaid coverage are white, 19 percent are Hispanic, 19 percent are black and 7 percent are "another race."

Eighty-two percent, or 12.4 million, do not have dependent children living with them. But parents would see their eligibility for Medicaid increased; currently few states cover parents who aren't disabled or parents where the mother is not pregnant.

"Increased health insurance coverage of parents should increase the extent to which their physical and mental health needs are addressed, reduce the financial burdens of health care and, as a result, have positive effects on their children and families as well," the study concluded.

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