Vice President for Health Policy
The Administration is expected to issue estimates this week of enrollment to date in health reform’s major coverage expansions, which take effect next January. Media reports (see here and here) indicate that Medicaid enrollment has significantly outpaced enrollment in the new health insurance marketplaces. That’s not a surprise, even apart from the well-documented technical problems affecting the federal marketplace website. Nor is it a cause for concern.
The quicker rate of Medicaid enrollments isn’t burdening states with unexpected costs — and it’s great news for the low-income individuals and families gaining coverage through the program. Research shows that Medicaid improves health and provides critical financial protection against catastrophic out-of-pocket medical costs.
As we explained last week, these key facts help put the rate of Medicaid enrollments in context:
This means that those who are eligible for Medicaid and CHIP are not eligible for premium credits to purchase coverage through the marketplaces. In other words, no one is unexpectedly choosing Medicaid coverage over subsidized marketplace plans and the fact that Medicaid enrollment is now outpacing marketplace enrollment doesn’t have an adverse effect on the marketplaces. (If their state isn’t adopting the Medicaid expansion at this time, individuals with incomes between 100 percent and 133 percent of the poverty line would be eligible for premium credits, however.)
Moreover, many people who will be newly eligible for the Medicaid expansion in 2014 are low-income individuals and families who are already eligible for and enrolled in other programs administered by states, which eases outreach and enrollment efforts. In addition, some states already had state-funded programs providing limited health coverage while others took up a health reform option to expand Medicaid early. These states are now automatically transitioning eligible individuals from these health programs to Medicaid.