Of the 26 states that chose to not expand Medicaid, 17 experienced a surge in enrollment, thanks in part to the woodwork effect of increased public awareness and outreach, finds a new Avalere Health analysis.
During last-minute efforts and hype to boost enrollment, many Medicaid-eligible residents who weren't previously enrolled signed up for coverage--more than 550,000 people in the 17 states did so between October and March, notes the analysis.
Georgia led the pack of nonexpansion states, with nearly 99,000 new Medicaid enrollees. North Carolina added 58,000 enrollees, while South Carolina and Tennessee each added nearly 54,000, according to McClatchy DC.
"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," Matt Eyles, executive vice president at Avalere Health, said yesterday in the announcement. "Though expansion states saw larger total enrollment increases, enrollment of these previously eligible individuals is significant in many nonexpanding states."
Under the healthcare reform law, the federal government pays the Medicaid bill for the first three years. Each state will have to account for some expenses come 2017; but by 2020, the government will still pay nearly 90 percent of the costs, notes Forbes.
"Though new eligibles are 100 percent federally funded through 2016, states only receive their standard matching rate for these previously eligible beneficiaries," said Caroline Pearson, vice president at Avalere Health, in the announcement. "As a result, many of these nonexpansion states that politically oppose the ACA are now facing unexpected financial and operational pressure due to woodwork enrollment."
Because open enrollment for Medicaid does not exist, last-minute sign-ups may continue while many states process Medicaid eligibility files, bringing the total number of enrollees even higher, according to the analysis.
What's more, states and insurers want clarification from the Obama administration regarding the law's provision that insurers must pay a fee to help expand benefits to the poor and uninsured, notes Forbes. Insurers are waiting to see how to factor the insurance tax into their rate-setting processes.