A new study set to be published in the April issue of the journal Health Affairs finds that Americans who are eligible for Obamacare’s optional Medicaid expansion — either because they’re newly eligible in a state expanding Medicaid, or because they were always eligible but never signed up — are in better physical and mental health and suffer from lower rates of expensive chronic medical conditions than those who were enrolled in Medicaid before the Affordable Care Act’s passage.
Essentially, that means the states currently on the fence about expanding Medicaid shouldn’t be worried about adding a large pool of sick and costly patients to the government program.
“Adults who were eligible for Medicaid but not enrolled before passage of the ACA and those in the income range for the ACA’s Medicaid expansion (“newly eligible”) had similar or better health than adults enrolled in Medicaid through a pathway other than disability before the ACA — in spite of the fact that the newly eligible were somewhat older than the currently enrolled,” wrote the study authors.
While more than 62 percent of Americans currently enrolled in Medicaid have at least one chronic illness, about 57 percent and 53 percent of newly-eligible people and previously-eligible but unenrolled people, respectively, had a chronic illness. That trend held true in both pro-expansion and anti-expansion states, meaning that states that choose to expand Medicaid in the future would be providing affordable care to millions of people with medical needs without making the overall Medicaid risk pool relatively sicker.
“Twenty-five states have opted not to use the ACA to expand Medicaid eligibility. If these states reverse their decisions, their Medicaid programs might not enroll a population that is sicker than their pre-ACA enrollees,” the researchers noted. “By expanding Medicaid eligibility, states could provide coverage to millions of healthier adults as well as to millions who have chronic conditions and who need care.”
New Hampshire became the latest state to accept Medicaid expansion this week, passing a so-called “private option” alternative that gives newly eligible residents generous federal subsidies to buy private health plans through the state’s Obamacare marketplace. The same private option in Arkansas has proven wildly successful and, so far, has come in at exactly the expected cost.