Law Lifts Enrollment in Medicaid by Millions
WASHINGTON - Enrollment in Medicaid has increased by three million people, to a total of 62 million, largely because of the Affordable Care Act, the Obama administration said Friday.
As expected, the increases have been much greater in states that expanded Medicaid eligibility.
'The increase in Medicaid enrollments across the country is encouraging, but more work is left to do,' said Kathleen Sebelius, the secretary of health and human services, who is trying to persuade more states to expand the program.
The new figures compare February enrollment in Medicaid and the Children's Health Insurance Program with the average monthly enrollment from July to September 2013, just before the health insurance marketplaces opened.
About half of the states, including California and New York, have expanded Medicaid. In states where the expansion was in effect in February, enrollment increased by 8.3 percent, to a total of 35 million people. In states that have not expanded Medicaid, enrollment was up 1.6 percent.
It was not immediately possible to confirm the government data. But the federal figures are consistent with estimates by independent experts.
Medicaid expansion is one of the two main policies that President Obama and congressional Democrats chose in extending health care coverage to more Americans. The White House reported this week that 7.1 million people had signed up through the other channel: private health plans sold in new insurance marketplaces.
The government numbers do not include people who enrolled in Medicaid last month in response to a publicity campaign by Mr. Obama and other officials. The Affordable Care Act requires most Americans to carry insurance. People seeking coverage had help from a small army of insurance counselors.
Edwin C. Park, an analyst at the Center on Budget and Policy Priorities, a liberal research and advocacy group, said the federal Medicaid data did not distinguish between newly eligible beneficiaries and those who were previously eligible but not enrolled.
Enrollment was up even in some states that have not expanded Medicaid. In Florida, the number of people on Medicaid rose 8.2 percent, to 3.2 million. In Montana, it was up 6.9 percent, to 149,000.
States with the largest percentage increases included Oregon, West Virginia, Vermont and Colorado, all of which have expanded eligibility.
Officials said the new numbers were underestimates. Not all states have reported data for February. The figures are also preliminary; some people will later be found eligible for Medicaid by the government, with coverage retroactive to February.
Many people who applied to the federal insurance exchange appeared to be eligible for Medicaid. The federal government is supposed to transfer their files electronically to state Medicaid agencies, but has had difficulty doing so.
People can sign up for Medicaid at any time. The open enrollment period for buying private insurance through federal and state exchanges ended on Monday, but the deadline did not apply to Medicaid.
In addition, Ms. Sebelius noted, there is no deadline for states to expand the program.
The mere existence of current enrollment data is one of the most remarkable features of the new report. The Department of Health and Human Services typically takes two years or more to publish such data, frustrating researchers and policy analysts. The Affordable Care Act simplified application procedures and required states to upgrade Medicaid information systems so that the federal government can now collect the data more quickly.
The Congressional Budget Office says that as a result of the health care law, eight million people are likely to gain coverage this year under Medicaid and the Children's Health Insurance Program, increasing federal spending by $19 billion.
In states that expand eligibility, coverage is generally available to people under age 65 whose incomes are up to 138 percent of the federal poverty level (up to $16,100 for an individual and $32,900 for a family of four).
In some states, the number of people qualifying for Medicaid under the new law exceeds the number obtaining private insurance. This unexpected pattern troubles some Republicans.
'The administration seems particularly proud of the fact that Obamacare has added hundreds of thousands of Americans to Medicaid,' said Senator John Cornyn of Texas, the chamber's No. 2 Republican. 'The problem is that Medicaid is a fundamentally broken program that is failing our neediest citizens.'
Enrolling in Medicaid is often easier than picking a private plan in an online exchange. The exchanges are new institutions, while state Medicaid agencies have decades of experience assessing eligibility and helping people enroll.
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