Affordable Care Act

Red states' Medicaid gamble: Paying more to cover fewer people

Illustration of a price tag hanging from an IV stand
Illustration: Sarah Grillo/Axios

Red states are getting creative as they look for new ways to limit the growth of Medicaid. But in the process those states are taking legal, political and practical risks that could ultimately leave them paying far more, to cover far fewer people.

Why it matters: Medicaid and the Children's Health Insurance Program cover more than 72 million Americans, thanks in part to the Affordable Care Act's Medicaid expansion. Rolling back the program is a high priority for the Trump administration, and it needs states' help to get there.

For low-income people, employer health coverage is worse than ACA

Illustration of heart monitor charting health care costs
Illustration: Sarah Grillo/Axios

There has been appropriate handwringing since 2010 about the affordability of Affordable Care Act plans in the marketplaces. But new data show that health insurance is decidedly less affordable for lower income people who get coverage at work than for their counterparts with similar incomes in the marketplaces.

Why it matters: It’s another example of how, when we focus so much on the ACA markets, we lose sight of problems in the employer-based health system where far more people get their coverage. For lower-wage workers, their coverage is decidedly worse than ACA coverage is.