Success of Medicaid expansion cause for celebration, concern

The battle over Medicaid expansion continues. While supporters of the program are thrilled with the enrollment figures, opponents fear the rising costs will plague states. 

Medicaid expansion under the Affordable Care Act has surpassed expectations by enrolling more than 12 million eligible Americans, reported Politico. Illinois has signed up nearly 541,000 individuals as of December; the state previously predicted enrolling 199,000 residents in 2014. Total enrollment reached 634,000 as of April.

Then there's Michigan. The state's first-year enrollment projection came in at 323,000 individuals. Sign-ups ended up reaching 605,000 before falling back to 582,000 earlier this month.

Opponents of the expansion believe that, because the federal government will stop picking up 100 percent of Medicaid expansion costs in 2016, slowly cut back to 90 percent after that, the expenses will be greater than anticipated and fall into states' laps.

"The expansion of Obamacare will cost our state taxpayers $5 billion," Florida Gov. Rick Scott (R) told Politico, referring to the 10-year cost. "Name the health care program--I think the only one is Medicare Part D--that cost less than what they initially anticipated…Historically, if you look at the numbers, with the growth in Medicare costs, Medicaid costs, it's always multiples."

Growing concerns of the "woodwork effect," which refers to eligible Medicaid individuals who are now just enrolling thanks to ACA outreach, may create budget problems for states that shunned the expansion as well as those that experienced higher-than-expected enrollment numbers, Matt Salo, executive director of the National Association of Medicaid Directors, told Politico.

While Medicaid supporters acknowledge the potential cost-related issues, many believe the historic decline in the uninsured will offset budgetary issues and in turn will provide significant health and economic benefits to states.

Many states remain in limbo over whether to expand Medicaid. For instance, Alaska Gov. Bill Walker (I) has faced legislative upheaval as well as strong opposition from state residents who claim the program is barely functioning, FierceHealthPayer previously reported.

For more:
- here's the Politico piece