What I would like to do is state the facts as we know them and clear up several misconceptions about the cost of expanding Medicaid.
• Fact number one: Implementation of the provisions of the ACA even without expanding eligibility will increase the cost of the Medicaid program.
This is because the ACA mandates expansion of coverage for current eligibility groups.
Medicaid coverage for foster children will be extended from 21 to 26 years of age.
Children age 6-18 who are currently covered at 100 percent of the Federal Poverty Level will be covered up to 138 percent of the FPL.
The ACA resets the way eligibility is determined by applying IRS standards to household composition and whose income counts toward eligibility.
These changes can result in greater eligibility.
Pressure from the health insurance individual mandate, referrals from the new health insurance exchange and loss of employer coverage will encourage individuals currently eligible for Medicaid benefits, but are not enrolled in the program, to enroll.
This is known as the “woodwork effect” and is the largest driver of ACA induced spending in the Medicaid budget without expansion.
David Dzielak Op-Ed