Survey: Big growth in Medicaid enrollees in expansion states

ATLANTA — States that opted to expand Medicaid under the Affordable Care Act saw enrollment increase on average by 18 percent during the first full year of expansion, according to a report released Thursday.

That will soon have an effect on state budgets, with expansion states to pay a portion of costs to cover the new enrollees beginning in 2017. Currently, the federal government is covering the expanded population at 100 percent. States will eventually pay 10 percent of costs by 2020.

In the 50-state survey, the Kaiser Family Foundation reported two-thirds of Medicaid directors in expansion states said enrollee costs were at or below what they had expected. And several of the states also reported savings in other areas of state spending, including behavioral health and criminal justice, along with an increase in revenue as a result of the expansion.

The survey noted 17 expansion states reported enrollment increases that exceeded original projections, which mirrors the results of an analysis by The Associated Press in July that found at least 14 expansion states were seeing an enrollment surge.

The AP analysis also found at least seven expansion states had already increased their cost estimates to account for the unexpected enrollees and that some lawmakers were concerned the spike could strain state budgets over time.

Financial analysts also note Medicaid enrollments tend to grow during tough economic times, which means states must be strong enough to continue to support the expanded programs through future downturns. Roughly two dozen states have been dealing with budget shortfalls for the current fiscal year.

Diane Rowland, director of the Kaiser Commission on Medicaid and the Uninsured, said most expansion states expect much slower enrollment growth this fiscal year. The survey found that improvements in the economy have allowed states to adopt more increases in reimbursement rates and benefits than restrictions.

“Medicaid is always a major issue in state budget discussions because Medicaid is such a large program and because it’s the largest source of federal revenue to the states,” Rowland said. “Historically, when states need to balance their budgets, one of the places they turn to is the Medicaid budget.”

Twenty states have not expanded Medicaid, with several citing costs as the reason.

For those nonexpansion states, the survey found an average enrollment increase of just over 5 percent in fiscal year 2015 as those previously eligible signed up for the program amid widespread media and outreach efforts.

State spending in the nonexpansion states reached an average of nearly 7 percent, although survey authors attributed that to routine changes in the federal reimbursement rate tied to the average personal income in each state.

___

Follow Christina Almeida Cassidy on Twitter: http://twitter.com/AP_Christina .

More in News

Jasmine Chavez, a crew member aboard the Quantum of the Seas cruise ship, waves to her family during a cell phone conversation after disembarking from the ship at Marine Park on May 10. (Mark Sabbatini / Juneau Empire file photo)
Ships in port for the week of June 15

Here’s what to expect this week.

Tlingit, Haida and Tsimshian people gather in Juneau for the opening of Celebration on June 5. (James Brooks/Alaska Beacon)
Federal judge considers lawsuit that could decide Alaska tribes’ ability to put land into trust

Arguments took place in early May, and Judge Sharon Gleason has taken the case under advisement.

(Michael Penn / Juneau Empire file photo)
Police calls for Tuesday, June 18, 2024

This report contains public information from law enforcement and public safety agencies.

(Michael Penn / Juneau Empire file photo)
Police calls for Monday, June 17, 2024

This report contains public information from law enforcement and public safety agencies.

Workers stand next to the Father Brown’s Cross after they reinstalled it at an overlook site on Mount Roberts on Wednesday. (Photo courtesy of Hugo Miramontes)
Father Brown’s Cross is resurrected on Mount Roberts after winter collapse

Five workers put landmark back into place; possibility of new cross next year being discussed.

KINY’s “prize patrol” vehicle is parked outside the Local First Media Group Inc.’s building on Wednesday morning. (Mark Sabbatini / Juneau Empire)
Juneau radio station KINY is using AI to generate news stories — how well does it get the scoop?

As trust and economics of news industry continue long decline, use and concerns of AI are growing.

An empty classroom at Juneau-Douglas High School: Yadaa.at Kalé on July 20, 2022. (Lisa Phu/Alaska Beacon)
Alaska faces consequences as federal education funding equity dispute continues

State officials offered feds a $300,000 compromise instead of $17 million adjustment.

Sen. Elvi Gray-Jackson, D-Anchorage, speaks on the Senate floor on March 6. Gray-Jackson was the sponsor of a bill to make Juneteenth a state holiday. (James Brooks/Alaska Beacon)
On Juneteenth, Gov. Dunleavy weighs adding a new legal holiday for Alaska

If the governor signs recently passed bill, Juneteenth would be observed as a state holiday in 2025.

Most Read