Medicaid Enrollment Surges Across the U.S.

Medicaid Enrollment Surges Across the U.S.

Much of the focus of the health care law in recent months has centered on whether the government could get millions of people to sign up for private health insurance through federal or state exchanges. But the Affordable Care Act also expands health insurance for Americans with the lowest incomes – by giving them greater access to public coverage through Medicaid and the Children’s Health Insurance Program.

The Department of Health and Human Services announced Monday 10.8 million low-income adults and children have enrolled in public health insurance since 2013, when the portion of the law involving the program took effect. The number represents an 18.6 percent increase in enrollment. Now, Medicaid and CHIP cover nearly 70 million people, or 1 in 5 people in the country.

Under the health care law more people can qualify for Medicaid based on their income. Newly included is anyone who makes less than 133 percent of the federal poverty line, which is $15,521 for an individual or $31,721 for a family of four.

The expansion of Medicaid, which is a state and federal program, was originally intended to reach all states. In June 2012, however, the Supreme Court ruled this portion of the law would be optional for state governments.

The District of Columbia and 28 states have expanded Medicaid. Alaska, Idaho, Montana, Tennessee, Utah and Wyoming are considering the move. The numbers of participants could increase quickly after each expansion, because people are allowed to enroll in the program at any time – unlike enrollment in government marketplaces for private insurance, which runs for three months.

While some state lawmakers oppose expansion for political reasons, others buckle at the cost of expansion. Medicaid takes up the largest share of state budgets, and continues to grow. As the population ages, Medicaid also picks up the tab for patients who are in nursing homes but can no longer afford the costs; it also covers Americans with disabilities. According to the Centers for Medicare and Medicaid Services, Medicaid spending grew 6.1 percent in 2013, to $449.4 billion.

Under the Affordable Care Act, the federal government picks up 100 percent of the tab for additional Medicaid enrollees, but gradually lowers the percentage of its support over time, leaving some fiscal uncertainties, according to the National Conference of State Legislatures.

“Medicaid has historically taken on an increasing share of revenues,” Dr. William Hazel Jr., secretary of the Virginia Department of Health and Human Resources, said Tuesday during a conference for the National Association of Health Underwriters.

In Virginia, Gov. Terry McAuliffe proposed to expand Medicaid, a move that ultimately was rejected by Republican-controlled House of Delegates.

Hazel says he thinks this was the wrong move, adding Virginia should have expanded Medicaid. “We need to have people insured if we are going to curb the costs of health care,” he says. “Our entire health care system has to deliver better value.”

In states that expanded Medicaid, enrollment is up 27 percent compared to 2013, according to the Department of Health and Human Services. States that have not expanded the program saw an average enrollment increase of 7 percent.

[ALSO: Advocates Push for Pregnancy Exception to Obamacare Enrollment]

Some Americans also have enrolled for private insurance that is subsidized by the government through tax credits to make it more affordable. Latest figures show 11.4 million Americans bought insurance or were re-enrolled in a plan from last year.

“Thanks to the Affordable Care Act, we’ve achieved a historic reduction in the uninsured – the largest over any period since the early 1970s – and the millions of people who signed up and re-enrolled during open enrollment add to that progress,” HHS Secretary Sylvia Burwell said Tuesday at a conference for the American Medical Association.

A Gallup Poll released Tuesday showed the rate of uninsured dropped 3.5 percentage points last year, from 17.3 percent to 13.8 percent.

In November, the Kaiser Family Foundation estimated 4 million Americans in states that did not expand Medicaid would be uninsured. Still, the number of people enrolling in Medicaid increased even in states that did not expand the program. Data are not available yet about which people previously qualified for Medicaid under old laws but did not enroll.

“A large portion of the growth in Medicaid is related to expansion, but there is a great number of people who were already eligible,” Jeff Myers, president and CEO of Medicaid Health Plans of America, said Tuesday at the underwriters’ conference. “You are seeing folks that should have been enrolled now enrolling.”

The Congressional Budget Office, the independent agency that makes economic projections about policy implementations, estimates ultimately 13 million Americans will join Medicaid.

Read full story at U.S. News & World Report

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