Medicaid enrollment up 15% in states that expanded under ACA

June 6, 2014

One in five Americans now receive their health insurance through Medicaid

One in five Americans (65 million people) now receive their health insurance through Medicaid, according to new federal data.

Enrollment has grown quickly in states that opted to expand their Medicaid programs under the Affordable Care Act (ACA) as oposed to those that did not adopt Medicaid expansion, according to an HHS blog. In states that expanded Medicaid, enrollment rose by 15.3% compared to the average enrollment from July through September 2013, while non-expansion states reported only a 3.3% increase in enrollment during that same time period.

At the end of April, 6 million more individuals were enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) compared to the period before the initial open enrollment began. That includes 1.1 million additional people enrolled in April compared to March in the 48 states that reported data for both months, according to Cindy Mann, Deputy Administrator of the Centers for Medicare & Medicaid Services (CMS) and Director of the Centers for Medicaid and CHIP Services. 

“Detractors of Obamacare argue that not all of this growth is due to the new law, as sign-ups by people who were already eligible for coverage are known in health policy circles as the woodwork effect,” says John Santilli of Access Market Intelligence, which provides market intelligence to the pharmaceutical and healthcare industries. “The increase in enrollment has also added to the technological and bureaucratic problems with HealthCare.gov connecting to Medicaid."

No state expanding Medicaid has experienced a decrease in enrollment.

“The new data illustrates a large difference between states that decided to participate in Medicaid expansion and those that did not,” Santilli says.

Application backlog

According to RollCall.com, 2.9 million enrollment applications-nearly half-have yet to be processed. 

For example, California has more than 900,000 unprocessed applications, Illinois has 330,000 and North Carolina has yet to process 286,000 applications, with an additional 13,000 that could include more than one person.

Even states that chose not to expand their Medicaid programs are seeing backlogs. For example, North Carolina has 170,000 applications pending, Georgia has 100,000 and South Carolina has 62,000. 

State agencies blame technology glitches between the federal website and state-run websites, coupled with a high volume of enrollees for the delay.