USA TODAY International Edition
Medicaid enrollment is health law’s bright spot
WASHINGTON Amid the low enrollment numbers for health insurance via the HealthCare. gov website, the Obama administration found one bright spot: Medicaid.
Almost 400,000 people have learned they are eligible to enroll in the states’ Medicaid programs, and the numbers are high even in Republican- dominated states that have chosen not to expand the program.
President Obama highlighted the Medicaid enrollment numbers Thursday as he took blame for the poor early performance of the health exchanges and for misleading some Americans that their health care policies would not change. Obama said the 396,000 new enrollees for Medicaid are something “that’s been less reported on, but it shouldn’t be.
About 106,000 Americans selected private health care plans in October, the first month the state and federal health exchanges were open — onefourth the number who were determined eligible for Medicaid.
That’s a boon for needy Americans seeking help for their health care, but an early sign the Affordable Care Act is so far more of a social welfare pro- gram than a way to get people to buy their own health insurance. Still, health experts say, their ability to get insurance could drive down everyone else’s costs.
The expansion included in the law allows states to provide Medicaid coverage for adults who make less than 138% of the poverty level for three years with the federal government paying all of the extra costs.
After three years, the federal share will remain 90% and the states will pay 10% of the expansion costs. Twenty- five states have so far declined to expand Medicaid, citing higher costs or opposition to the Affordable Care Act.
North Carolina, which chose not to expand Medicaid, determined 7,404 people were eligible for Medicaid, while about 1,600 have chosen an insurance plan through the federal exchange.
“Even in a state where we didn’t expand, more people signed up for Medicaid,” said Don Taylor, associate professor of public policy at Duke University’s Sanford School of Public Policy. But he said that “might be expected” when the coverage is free.
There are several reasons for the growth in Medicaid patients, said Sara Dash, a researcher at Georgetown University’s Health Policy Institute. They include:
The “welcome mat” effect comes when people already know Medicaid is available, but they don’t know they’re eligible until they visit an exchange site and enter their information.
The Affordable Care Act required the states to streamline the enrollment process.
It’s just easier to sign up for Medicaid because beneficiaries don’t have to compare plans and pay a fee.