The federal health care overhaul is likely to boost enrollment in Medicaid by people who are already eligible but not currently enrolled, according to a University of Minnesota study that seeks to quantify the "welcome-mat effect."
And that means states will face higher Medicaid spending and caseloads, even states that don't opt to expand their Medicaid programs under the Affordable Care Act, the researchers concluded in in a study published Wednesday in the journal Health Affairs.
Using the 2006 health care overhaul in Massachusetts as a model, the researchers calculated that among low-income parents who already had been eligible for Medicaid and did not have other insurance coverage, Medicaid enrollment increased by 19.4 percentage points compared with a control group of other states. They selected Massachusetts as a case study because its program was on a scale and scope similar to the federal overhaul.
Policymakers have widely anticipated that Medicaid enrollment among the already eligible will rise as the federal overhaul makes insurance coverage mandatory for nearly everyone next year, said lead researcher Julie Sonier. But she said the study seeks to give states a better idea of how big this "welcome-mat effect" might be.
The effect could be larger in some states and smaller in others depending on how much outreach they do, Sonier said. States that have opted not to expand their Medicaid programs to include more working poor or that have decided to let the federal government run their health insurance exchanges might not do as much promotional work, she said. And she noted that Massachusetts started out with fairly high Medicaid enrollment, so it had less room for improvement than other states.
The study was funded by the Robert Wood Johnson Foundation.
The study can be found at: http://content.healthaffairs.org/lookup/doi/10.1377/hlthaff.2013.0360