Surges in Medicaid enrollment raise concerns about state budgets

July 18, 2015

More than a dozen states that opted to expand Medicaid under the ACA have seen enrollments surge way beyond projections, raising concerns that the added costs will strain their budgets when federal aid is scaled back starting in two years. Several expansion states have already revised their budget estimates due to the larger than expected enrollments, according to an Associated Press review. Expansion supporters downplay the budget concerns, pointing to studies that indicate the economic benefits of expanding healthcare will result in significant savings over time. Thirty states and the District of Columbia have expanded Medicaid, or plan to do so, to include all adults with incomes at or below 138% of the federal poverty level, currently $16,243 for an individual. The federal government agreed to pay all costs for the new enrollees through 2016, but it will begin lowering its share in 2017. States will pay 10% of the costs by 2020. In the expansion states, enrollment for Medicaid and a related program for children have increased an overall 28.2% compared with a three-month period before the law's implementation, according to the federal government. In a recent report, economic experts at HHS said they expect estimated enrollment and per-person cost increases to level off and even decline over the long run. In states where ongoing discussions over Medicaid expansion have yet to be resolved, opponents are quick to cite the surging enrollments and costs. 
Related News:
New York exchange adds 1.1 million to Medicaid - The Wall Street Journal
Maryland Medicaid enrollment much higher than forecast - The Washington Post