Medicaid spending, enrollment to rise--even in states without expansion

States can expect a big spike in Medicaid enrollment and spending, even in those states that have refused to expand the state-federal health insurance program under the healthcare reform law, according to a new report by the Kaiser Commission on Medicaid and the Uninsured.

The report projects enrollment in Medicaid will rise on average by almost 9 percent in fiscal year 2014. The number of people signing up for Medicaid will increase by nearly 12 percent in the 25 states expanding the eligibility requirements to income threshold for adults with children to 138 percent of the federal poverty level.

But even those states that have refused or haven't yet committed to expanding eligibility will see a jump in enrollment of 5 percent as more people learn about the program through outreach campaigns designed to increase awareness about online health insurance exchanges and participation.  

Spending also will increase by about 10 percent across all states, according to the report, which is based on the 13th annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by Kaiser and Health Management Associates.

The report also found:

  • State spending growth will average 13 percent among the states that have expanded eligibility and 6.8 percent among those that will not;
  • Only three states (Louisiana, Maine and Wisconsin) project a decrease in Medicaid enrollment in FY 2014 because they intend to reduce eligibility levels; and
  • Nearly all states report they are developing and implementing payment and delivery system reforms to improve quality and manage costs.

For more:
- read the report (.pdf)

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