WASHINGTON (AP) — States that thus far have refused a federal offer to expand Medicaid are still seeing significant sign-ups for the safety-net program that serves the poor, according to a report Tuesday that raises political and budget implications.
The market analysis firm Avalare Health estimated that at least 550,300 more people signed up for Medicaid through the end of March in 17 out of 26 states that have not yet expanded eligibility for the program under President Barack Obama's health care overhaul. The actual number could be markedly higher since Avalere did not report data for populous Florida.
The catch for these states is that they could be getting billions of dollars more from the federal government if they had expanded eligibility for their Medicaid programs. Instead, the federal contribution for their additional beneficiaries gets determined under a less generous funding formula.
"I don't think a lot of these states anticipated the kind of enrollment they would be getting," said Avalere CEO Dan Mendelson. "The states are going to have to figure out a way to pay for the increase."
Georgia topped the list, with nearly 99,000 new Medicaid beneficiaries. North Carolina followed, with 58,000. In percentage terms, Montana saw the largest increase, just over 10 percent.
Virginia, where Medicaid expansion has led to a political impasse between new Democratic Gov. Terry McAuliffe and GOP lawmakers, had nearly 37,000 new beneficiaries, a 3.6 percent increase.
But Texas, with the highest proportion of uninsured residents of any state, saw hardly any increase.
Beginning this year, the health care law expanded Medicaid eligibility to people making up to 138 percent of the federal poverty level, about $16,100 for an individual. The goal was to provide coverage for low-income adults with no children living at home.