By the end of Obamacare’s open enrollment period, six million additional low-income Americans were enrolled in public insurance programs compared to the period before the health law’s coverage expansion, according to a new report from the Health and Human Services Department. The new enrollees were most highly concentrated in the states that agreed to expand their Medicaid programs.
Those six million people — who include enrollees in both Medicaid and the Children’s Health Insurance Program (CHIP) — are in addition to the eight million Americans who signed up for private plans on Obamacare’s state level insurance markets between October and April. Government officials are cautioning that the number of new public insurance enrollees may actually be even higher than that, since not every state has reported their data yet. And unlike the open enrollment period for the private marketplaces, people can enroll in Medicaid year round.
However, those gains aren’t being shared equally across states. “As we’ve seen for months, growth was more pronounced in states that adopted the Medicaid expansion: Enrollment in those states rose by 15.3 percent compared to the average enrollment from July through September 2013 while states that have not expanded reported only a 3.3 percent increase in enrollment during that same time period,” health officials explained in a blog post.
The disparity between the expansion and non-expansion states isn’t surprising. For months, the uninsurance rate has been falling faster in the states that have embraced the central tenets of Obamacare, including the expansion of Medicaid coverage to additional low-income residents. Meanwhile, thanks to GOP lawmakers’ continued resistance to this aspect of health reform, some of the poorest Americans have been locked out of health reform altogether.
Not every person who signed up for Medicaid over the past six months was a direct beneficiary of Obamacare’s expansion of the program. Some of them were likely simply re-enrolling in coverage. Others, such as the new enrollees in the states that didn’t agree to expand Medicaid, may have already been eligible for coverage, but didn’t sign up until the news coverage around Obamacare made them more aware of their health care options. Health policy analysts call that the “woodwork effect.”
Still, the Department of Health and Human Services notes that Obamacare is playing a big role. “Because of the Affordable Care Act, many consumers now have access to new, affordable, private health insurance options in the Health Insurance Marketplace, while many others are now eligible for their state’s Medicaid programs,” officials write.