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Rebecca Farley

Director, Policy & Advocacy, National Council for Behavioral Health

Medicaid Enrollment Rises Even in States that Opted Out of Expansion

May 15, 2014 | Medicaid | Comments
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States that opted out of the Affordable Care Act’s Medicaid expansion are still experiencing Medicaid enrollment increases, according to a new analysis by Avalere Health. The healthcare consulting firm found that in 17 of the 26 states that did not expand Medicaid, enrollment grew by more than 550,000 patients. The increases ranged from a low of 0.1 percent in Texas to 10.1 percent in Montana. Enrollment growth exceeded 50,000 beneficiaries in Georgia, North Carolina, South Carolina, and Tennessee.

Avalere attributed the enrollment increases to individuals who were previously eligible for – but not enrolled in – Medicaid signing up as a result of increased outreach and awareness. Although the federal government is covering 100% of the cost for newly eligible Medicaid enrollees in expansion states through the end of 2016 (phasing down to 90 percent thereafter), traditional matching rules apply for individuals who were previously eligible even if they did not enroll. Thus, both expansion and non-expansion states will find themselves on the hook for their share of the costs incurred by these previously eligible individuals.

“The push to enroll in exchanges has brought a substantial number of new beneficiaries into Medicaid, even in states that decided not to expand their Medicaid programs,” said Matt Eyles, executive vice president at Avalere Health. “Though expansion states saw larger total enrollment increases, enrollment of these previously eligible individuals is significant in many non-expanding states.” For example, enrollment of previously eligible but unenrolled individuals in California is expected to exceed the original projected rates by 60 percent.

Map reposted from: The Advisory Board Company