AAFP Testifies on Medicaid Expansion, Health Insurance Exchanges

In testimony (4-page PDF; About PDFs) submitted to the House Energy and Commerce Committee, the AAFP has reiterated its support for two key provisions of the health care reform law: Medicaid expansion and the establishment of health insurance exchanges.

According to AAFP Board Chair Glen Stream, M.D., M.B.I, of Spokane, Wash., expanding Medicaid and creating health insurance exchanges will increase access to care, resulting in a significant step forward for U.S. health care.

"We believe that our health care system benefits from universal health care coverage, and individuals should have a continuous relationship with a family physician, which is more likely if they have consistent health care coverage," said Stream in written testimony to the House committee, which held a Dec. 13 hearing on Medicaid expansion and implementation of health insurance exchanges.

The Patient Protection and Affordable Care Act calls on states to expand their Medicaid eligibility requirements to 133 percent of the federal poverty level for nondisabled individuals younger than age 65. The Affordable Care Act also requires states to establish health insurance exchanges by 2014 to allow individuals and small businesses to compare and purchase private health insurance plans.

If adopted by all 50 states, the Medicaid expansion would provide coverage to more than 21 million uninsured individuals, cutting in half the number of uninsured in the United States, according to an AAFP summary (18-page PDF; About PDFs). The state health insurance exchanges, meanwhile, will improve access to health insurance for consumers.

"Research consistently shows that people who have health insurance coverage, whether private or public, are more likely to have a usual source of care, better overall health, and better control of chronic conditions. Studies also demonstrate that people without insurance skip or delay needed preventive services and postpone care during early, easily treated stages of an illness," said Stream in the testimony.

"Failure to expand Medicaid does not simply deny coverage to the most vulnerable individuals, it affects the entire community, who feel the impact of treating the poor and seriously ill."

Stream also said the Medicaid expansion and health insurance exchanges provide a way for moving ahead with the patient-centered medical home (PCMH) and for making the PCMH "the foundation of a new health care system that is built on a foundation of continuous and comprehensive primary care."