Medicaid Expansion

Every month the CMS division of the HHS Dept. issues a formal Medicaid/CHIP enrollment report, and pretty much every month (until now) the numbers have grown rapidly. This has been the case even during the "off-season", since there isn't an off season for Medicaid/CHIP enrollment; those eligible for the programs can enroll year-round (on the other hand, promotion/outreach efforts are higher during Open Enrollment, so enrollment does still tend to be more rapid during that period).

As of the end of June, this trend was still continuing: While not hitting the half-million plus rates of many earlier months, nearly 300,000 more people still signed up in June.

292,112 additional people were enrolled in June 2015 as compared to May 2015 in the 51 states that reported comparable June and May 2015 data.

With South Dakota's DAKOTACARE dropping off the ACA exchange and asking for 63% rate hikes, this (potential) development can't come soon enough:

South Dakota may join 30 other states in expanding its Medicaid program if federal officials approve a plan Gov. Dennis Daugaard is set to outline to the nation’s top health and human services administrator in Washington on Tuesday.

The Republican governor is meeting with Health and Human Services Secretary Sylvia Burwell to explain the plan, and the federal government has so far been more open to discussions than in the past, said Tony Venhuizen, chief of staff to Daugaard. The proposal, which is in its early stages, would make about 48,500 South Dakota residents newly eligible for the program.

The twist this time is that the Indian Health Service, which provides healthcare coverage for around 2 million Native Americans nationally, would be involved:


There's not one, not two, not three but four articles I'm reading this morning centering around the same theme: GOP governors who are finally starting to at least consider expanding Medicaid under the Affordable Care Act, but only if the enrollees jump through various hoops in order to qualify:

Sarah Wheaton, Politico:

In nearly a dozen Republican-dominated states, either the governor or conservative legislators are seeking to add work requirements to Obamacare Medicaid expansion, much like an earlier generation pushed for welfare to work.

The move presents a politically acceptable way for conservative states to accept the billions of federal dollars available under Obamacare, bringing health care coverage to millions of low-income people. But to the Obama administration, a work requirement is a non-starter, an unacceptable ideological shift in the 50-year-old Medicaid program and a break with the Affordable Care Act’s mission of expanding health care coverage to all Americans. The Health and Human Services Department has rejected all requests by states to tie Medicaid to work.