About 1.5M Americans Deemed Eligible for Medicaid, CHIP in October
Nearly 1.5 million people were determined to be eligible for Medicaid or CHIP in October through the state and federally run health insurance exchanges, according to a CMS report released Tuesday, The Hill's "Healthwatch" reports (Viebeck, "Healthwatch," The Hill, 12/3). That figure is significantly higher than the 106,200 people who had selected a private plan in either the state or federally run exchanges, according to the New York Times' "In Practice" (Pear, "In Practice," New York Times, 12/3).
Under the Affordable Care Act, U.S. residents with incomes up to 138% of the federal poverty level are eligible for Medicaid. However, the U.S. Supreme Court last year ruled that states could opt out of the expansion. For states that opt in, the federal government will cover 100% of the cost of the expansion until 2016, after which the federal share will decline gradually until it reaches 90% in 2020 (California Healthline, 8/7).
The report -- which is the first in a series of monthly reports to be released by CMS -- highlights data from all state Medicaid and CHIP agencies on individuals who applied for Medicaid between Oct.1 and Oct. 31. The report did not distinguish between newly eligible enrollees -- who became eligible because of the ACA's expansion -- and those who previously were eligible for Medicaid and sought to enroll because of the publicity surrounding the program expansion.
Overall, the report found that 1.46 million U.S. residents applied or were determined eligible for Medicaid or CHIP in October. Specifically, states that are fully expanding their Medicaid programs under the ACA experienced a 15.5% increase in applications, while applications in states that have opted out of the expansion increased by 4.1%.
Among states that are expanding their Medicaid programs, California had the most eligibility determinations, with 149,098 state residents deemed eligible for Medicaid or CHIP. Meanwhile, Florida -- with 164,993 -- had the highest number of eligibility determinations among states that reported their data to CMS but have opted not to expand Medicaid under the ACA (Evans, "Capsules," Kaiser Health News, 12/4).
According to "In Practice," 48% of newly eligible beneficiaries -- or 697,000 U.S. residents -- were in states that opted out of the Medicaid expansion, confirming expectations that many of those eligible for Medicaid but not enrolled would come forward and seek coverage in part because of increased public awareness about the program.
CMS spokesperson Emma Sandoe said the data show that the ACA "is making it easier for low-income individuals to get health insurance, by simplifying the system and allowing them to fill out one application to find out if they qualify for Medicaid or tax credits for private health insurance" ("Capsules," Kaiser Health News, 12/4).
Meanwhile, in a blog post, HHS wrote that the numbers show "a real need and desire for coverage for low-income Americans," even for those living in states that have not expanded their Medicaid programs.
Meanwhile, critics of the law contend that the ACA is ramping up enrollment in a "broken" program, according to the Washington Times. In addition, opponents of the law note that Medicaid enrollment is far outpacing signups for private coverage, which they attribute to the flawed federal health insurance exchange website (Howell, Washington Times, 12/3).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.