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.