By Jonathan D. Williams
Although there has been much publicity of the early rollout of the health care exchanges for purchase of individual health care coverage under the Affordable Care Act (ACA, a.k.a. “Obamacare”), a key part of the overall health care reform overhaul appears to be off to a very robust start in states that agreed to accept federal money to expand Medicaid. In an AP article published today, it is reported that in the 10 states that have reported data, approximately 444,000 individuals have signed up for Medicaid since open enrollment began.
Previously, Medicaid was available only for those who not only demonstrated financial need, but also belonged to a vulnerable population, including the aged, blind, or disabled; pregnant women; families with children; and those in need of long-term care in a nursing facility. As part of the 2009 ACA health care reform, Medicaid was to be expanded to be available for all who demonstrated the requisite financial need, regardless of other factors. The Supreme Court’s decision on the ACA allowed states to opt-out of the expansion, and many have done so, including North Carolina. This puts additional strain on the health care exchanges in those states. However, in states that are participating in the expansion of Medicaid, it appears that enrollment is high, in line with most observers’ expectations.