Aside from the Obama Administration offering an optional package of fully funded Medicaid expansion dollars to states for the next three years, the concept of expansion is nothing new. States have already chosen to expand their Medicaid populations well before the passage of the Affordable Care Act in hopes of reducing the number of uninsured. However, just the opposite has occurred.
Medicaid Expansion triggers a vicious cycle:
- Actual enrollment increase greatly surpasses projected enrollment increase.
- Medicaid population influx yields a significant drop in private insurance, also known as private coverage “crowd-out”.
- Caring for childless adults cost more than low-income parents (childless adults represents expanded eligibles).
- The uninsured rate increases or stays stagnant at best.
This repetitive process occurs in the following states: Arizona, D.C., Delaware, Maine, Michigan, Oregon, Utah, Vermont.
The Foundation for Government Accountability discusses this counter-productiveness in more detail here.