Enrollment in Medicaid could soar by 73 percent, to nearly 55 million people, a new study states.
The increase result not only from the economic downturn caused by the pandemic crisis but also from recent “congressional hand-tying” restricting states from moving ineligible enrollees off Medicaid.
“States will need to fund nearly $128 billion of those costs with state revenues, while federal tax payers will be on the hook for the rest,” write authors Nicholas Horton and Johnathan Ingram in the study released on June 10 by the Foundation for Government Accountability.
Hardest-hit will be states that expanded Medicaid under Obamacare to able-bodied adults based on income, not disability, write the authors. The pandemic will cause enrollees to move in and out of income eligibility as they return to work, but under the CARES Act and the Families First Coronavirus Response Act, Congress is restricting states from moving enrollees off the rolls.
The increased funding for Medicaid (6.2 percent) will not apply to expansion costs but to traditional Medicaid only, the authors note.
“So, as expansion states enroll more and more able-bodied adults, they will bear more of the brunt of those costs,” write Horton and Ingram.
Nearly a Half-Trillion Dollars
Medicaid spending could soar by more than $440 billion, of which states will have to pick up varying amounts, the report states. The authors calculate how much states will have to pay out of their own budgets based on anticipated Medicaid growth as a result of the recession and congressional restrictions on removal of enrollees. California has the highest prospective payout, at $20.1 billion, and Wyoming will have the lowest burden, at $159.1 million.
Lawmakers must act now to give states relief by allowing them more control over their Medicaid programs, the authors write.
“Congress should be giving states more tools to manage and preserve Medicaid for those who need it most,” write Horton and Ingram. “Unfortunately, they have done the exact opposite, but they still have time to get it right.”
Nicholas Horton, Jonathan Ingram, “States Are About to be Hit by a Medicaid Tidal Wave,” The Foundation for Government Accountability, June 10, 2020: https://www.heartland.org/publications-resources/publications/states-are-about-to-be-hit-by-a-medicaid-tidal-wave