ACA [Obamacare]: Doing well–and doing good–in states that expanded Medicaid

At the same time that private-insurance enrollment via healthcare.gov is experiencing technical difficulties, the other side of the Affordable Care Act—the side that makes it possible for more people to qualify for Medicaid—is gaining ground.

Under the Affordable Care Act, states are encouraged—and financially incentivized to the tune of hundreds of millions of dollars—to expand Medicaid eligibility to a wider swath of low-income individuals and families. In the enlightened states [those with Democrats in the Governor’s mansion and/or a Democratic majority in their states’ legislatures] that have not blindly rejected Medicaid expansion, new enrollments in Medicaid are trending up and are expected to grow.

Overall, in 24 states (plus Washington, D.C.) that are going ahead with Medicaid expansion, more than 8.7 million people are expected to be newly enrolled, according to the Centers for Medicare and Medicaid Services. Click here for a chart that shows the status of Medicaid expansion state-by-state.

Think Progress  surveyed news reports from the states that have chosen to expand Medicaid under ACA and found that “the program is responsible for thousands and of new enrollments and appears more successful in enrolling uninsured Americans than private insurers operating in the exchanges.”

CONNECTICUT: Of the 3,847 individuals who signed up for coverage, 1,857 qualified for Medicaid, 1,897 signed up for plans with one of the three private insurance carriers, and 93 qualified for the Children’s Health Insurance Plan. Of the individuals who signed up with private carriers, 772 won’t receive a subsidy and 1,125 will receive a federal subsidy to lower their monthly premium.” [CT News Junkie]

MARYLAND: “About 82,500 people had signed up for Maryland’s expanded Medicaid program as of Friday, more than 30 times the 2,300 Marylander’s who managed to enroll through the state’s insurance exchange.” [Politico]

OREGON: “Though Oregon’s health insurance exchange is not yet up and running, the number of uninsured is already dropping thanks to new fast-track enrollment for the Oregon Health Plan. The low-income, Medicaid-funded program has already signed up 56,000 new people, cutting the state’s number of uninsured by 10 percent, according to Oregon Health Authority officials.” [The Oregonian]

ILLINOIS: “The sign-up process apparently hasn’t been as difficult for Illinoisans poor enough to qualify for the health-care law’s federally funded expansion of Medicaid eligibility, which the General Assembly approved this year without a single Republican vote. Those applicants are routed to the state’s ABE website for Medicaid.” [The State-Journal Registrar]

WEST VIRGINIA: “More than 50,000 West Virginians have already enrolled in the state’s Medicaid program that was expanded under the Affordable Care Act….But most new Medicaid signups came through an auto-enrollment program DHHR began in the weeks leading up to the opening of the insurance marketplace.” [Charleston Daily Mail]

ARKANSAS: “After two weeks of enrollment, a total of 56,288 adults have told the Arkansas Department of Human Services (DHS) they want to enroll in the “private option” health insurance program, [the state's Medicaid expansion] according to data released Tuesday. From Oct. 1 through Oct. 12, DHS received 1,509 applications through its state-run web portal and 1,119 telephone and paper applications. That is in addition to the 53,660* current DHS clients who have already been determined eligible and returned letters saying they wanted coverage.” [Arkansas Department of Human Services]

That’s good news in those states where the interests of all people are priorities. But it’s bad news for the hundreds of thousands of low-income people who are—once again—being left behind, in the 26 states where hating Obama and stopping his programs at any cost is more important than helping citizens gain access to the basic health services that they deserve. Because their states have rejected Medicaid expansion, an estimated 8 million people are expected to remain outside of the expanded healthcare coverage envisioned by the ACA.

Under the terms of the ACA, Medicaid coverage was intended to be expanded to all adults with incomes up to 138 percent above the federal poverty line (which amounts to $15,856 for an individual), money that would be covered by the federal government at 100 percent of cost until 2016, and at 90 percent thereafter.

However, under a U.S. Supreme Court ruling on the ACA in June 2012, the federal government was barred from mandating states to enact Medicaid expansions. As a result, an insurance coverage gap currently exists where millions of people making less than $11,500 per year ($23,500 for a family of four) will have too much income to qualify for Medicaid but not enough to receive federal subsidies when purchasing insurance on a state-run health exchange.

That is a sad commentary on the state of Republican state governance in America. We can only hope that the legislators who rejected Medicaid expansion will see the light–or the color of the federal money that they are turning down because it’s “tainted” by the President’s agenda–and get on board–or get voted out of power by the people they are screwing.

Gloria Shur Bilchik Gloria Shur Bilchik (462 Posts)

Gloria Shur Bilchik is a freelance writer and community volunteer in St. Louis, Missouri. She is the editor of Occasional Planet. She views the preservation of progressive values as vital to making the US a humane, livable place for her children and grandchildren.