Filling the Medicaid coverage gap could be a boon for payers

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Congress is eyeing two options for cutting down the 2.2 million-person Medicaid coverage gap, and insurers could see profits either way. 

Through current efforts to expand Medicaid via reconciliation bill, politicians are aiming to either insure Americans through ACA marketplaces or a CMS-helmed federal exchange program that would feature limited or no cost-sharing, Morning Consult reported. 

Either way, insurers are poised to benefit, as ACA marketplaces follow the status quo and federal initiatives may be contracted to private payers. 

Centene, Molina Healthcare and UnitedHealth saw Medicaid revenue blossom in 2020, while the three along with Aetna and Anthem saw enrollment grow by 12 percent and 56 percent depending on the payer, according to Morning Consult. Especially notable is Centene, which has 16 percent of its patient base within the expansion population. 

"[Insurers] seemed especially interested in entering non-expansion states this year — especially the big ones," said Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation. The "big ones" include states like Georgia, Florida, North Carolina and Texas.

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