Dive Brief:
- 25 states have adopted Medicaid expansion under the Affordable Care Act, bumping eligibility in the program to people with incomes up to 133% of the federal poverty. As expected, Medicaid enrollment in those states has jumped 18%—a growth of more than 6.25 million since open enrollment.
- But even in states that haven't expanded their programs, the number of people enrolling in the program has increased. The number of people on the rolls in the remaining states grew by 4%, or nearly 975,000 people, over the same period of time.
- Although no changes were made in these states, the trickle down effect of the ACA made many people aware that they may be eligible for the program. According to a Health Affairs study from 2012, not even half of people who are eligible for Medicaid are enrolled in the program.
Dive Insight:
Expanding Medicaid and getting people enrolled is crucial for hospitals, particularly nonprofits and safety nets, which bear a disproportionate share of uncompensated care costs. According to the American Hospital Association, hospitals provided more than $45 billion in uncompensated care in 2012.
A report released this summer by the Colorado Hospital Association studied the impact of Medicaid expansion on hospitals. Between the first quarter of 2013 and the first quarter of this year, Medicaid charges increased 3% in 15 states that expanded Medicaid. Self-pay charges also dropped in expansion states, as did charity care, which declined by 32%. In states that didn't expand, Medicaid charges were stagnant and both self-pay patients and charity care increased.
