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Medicaid coverage expansion – status update

The fine folks at the Kaiser Foundation held a webinar on Medicaid expansion today; here are a few of the highlights I picked up…

WA and MN showing significant increases in enrollment

AR IL WV are enrolling via SNAP – facilitates enrollment

Estimate total enrollment COULD go up as much as 21 million but that’s including everyone who is currently eligible and those in all states that could participate by 2022.

As of now, there are 26 states moving forward w Medicaid, with  Ohio just joining this week. (here’s the map showing state status) Among the states that may consider expansion in the future; NH may do this in November in a special legislative session, PA may be moving in this direction as well.  Interestingly, the map looks just like it did in 1965 when states originally could decide to adopt Medicaid or not. About half adopted Medicaid that first year, and most of the rest did within a few years.

In the states that are not expanding Medicaid, the median eligibility level for parents is 47% of poverty level, or $9400 a day for family of three. In almost all non-expansionary states, there is no coverage for individuals.

Nationally 4.8 million individuals are in the coverage gap due to states not deciding to expand, 22% of these are in Texas, 16% in FL. The vast majority are NOT eligible for those states’ current Medicaid program.

Currently enrollment via state exchanges seems to be heavily Medicaid focused.

Hospital uncompensated care payments will be reduced for DISH payments; the feds are reducing the amount of funds they are transferring to hospitals that provide a lot of uncompensated care and Medicaid services. The federal DISH allotments are established, HHS has formula in place for rolling out those changes but that formula doesn’t account for states that don’t decide to use expansion. Thus states that don’t expand Medicaid will see a reduction in these payments, and no increase in Medicaid, leaving the hospitals in a financial bind.  

What does this mean for you?

I’d expect more states to accept Medicaid expansion over the next few years.

5 thoughts on “Medicaid coverage expansion – status update”

  1. Someone told me about your blog, first time visitor.
    I was just reading the section on Medicare/Medicaid for Oct. 24th and you named only two states that were not going to participate in the Medicaid Expansion for they were Texas and Florida. I feel you should either offer a link to the appropriate information or you should provide the information. Because many of your readers are uninformed and are trusting your guidance as truth and they do not realize that much of the information is not provided. I believe that journalist should be unbiased at least in their reporting, although I know that they have an opinion but should keep it private to be objective. I am a Medicare/Medicaid Insurance agent in Florida, and have been for about six years. I have some insight on this as I work in it everyday all day, all year. I see the good the bad and the very ugly from both sides, the recipients and the government agencies. There is more to the story than just the have decided to not participate. How about but why?

    1. Maria
      Thanks for the note.
      Not sure what the issue is as I clearly stated that many states had not expanded Medicaid and provided a link to a site with the latest information. I cited texas and Florida only because they are states with the highest percentage of the population without insurance.

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Joe Paduda is the principal of Health Strategy Associates



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