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Medicaid Rolls Are Expanding Under The Affordable Care Act

May 16, 2014

Regardless of which side of the political spectrum one finds himself on, one fact is indisputable – the Affordable Care Act (ACA) has increased the number of Americans with health insurance, and in many cases, public aid.  Specifically, through expanded Medicaid coverage and more effective outreach and enrollment strategies, more than 3 million people have been added to the Medicaid and Children’s Health Insurance Program (CHIP) since September 2013, according to most recent government data.

Medicaid Enrollment ChartThe most recent report from the Centers for Medicare & Medicaid Services (CMS) has found that 3,019,976 individuals applied and qualified for Medicaid or CHIP since the beginning of open enrollment under ACA in September 2013 through the end of February 2014.  Not surprisingly, the bulk of that increase occurred in states expanding their Medicaid programs.  Even more alarming is that more than 10% of the increase in enrollment occurred in states that chose not to expand.  This surprising statistic highlighted the point that many individuals and families were not aware that they were eligible for these assistance programs.

One state whose residents greatly benefited from this phenomenon despite the state’s decision not to expand Medicaid is Florida.  More than 245,000 Floridians, including 51,000 children, were added to state Medicaid and CHIP rolls since last fall.  This is by far the largest gain among states that did not expand their state programs.  Even among states that did expand Medicaid, only California and Washington added more enrollees than Florida.

Part of the reason for this success is the “no wrong door” policy created by the ACA.  This means that individuals can apply for health coverage through a number of different gateways, including Healthcare.gov, the national healthcare marketplace, as well as the state Medicaid or CHIP agency.  Regardless of which “door” they choose, individuals can get eligibility determinations for all types of health coverage and have their cases automatically routed to the program for which they are eligible.

In addition, in response to CMS guidance provided last year, some states are employing a new tool for facilitating Medicaid enrollment known as an “administrative transfer”.  This method uses Supplemental Nutritional Assistance Program (SNAP) income data information to identify and target outreach efforts for those individuals who are likely to be eligible for Medicaid and CHIP.  Five states, including Arkansas, California, Illinois, Oregon, and West Virginia, have implemented this strategy, resulting in over 450,000 in new enrollees.

As other states expand and fine tune their marketing and outreach programs and employ new enrollment techniques, it is very likely that the recent trend of increasing Medicaid and CHIP participation will continue to accelerate. Although opponents may see this expansion of government assistance programs as controversial, they would be hard-pressed to dispute the fact that changes in eligibility and enrollment processes ushered by ACA are likely to promote coverage among previously eligible but uninsured adults and children, resulting in greater access to affordable healthcare coverage for those who need it most.

Accelify has experience helping school districts maximize their outreach efforts to expand Medicaid enrollment for students and their families.  Schools are also eligible to claim Medicaid reimbursements for the costs incurred providing outreach.  For more information on how Accelify can work with your district to expand its outreach efforts, contact info@accelify.com.