Idaho Medicaid enrollment climbs

adutton@idahostatesman.comApril 22, 2014 

The number of people on Medicaid in Idaho rose almost 6 percent since the launch of Idaho's health-insurance exchange last fall even though Idaho is one of the states that has not expanded Medicaid eligibility under the Affordable Care Act.

The increase is sharper than usual. That's partly because more people discovered they qualified for Medicaid during the process of shopping for health insurance to comply with the Affordable Care Act, which requires all Americans to be insured.

It's also because Idaho is now using federal systems to check information for Medicaid renewals, making the process smoother for people already enrolled in the program, according to the Idaho Department of Health and Welfare.

"This is a positive change for Idaho, as it ensures that those who are eligible for Medicaid can maintain coverage without burdensome administrative processes that cause individuals to [lose Medicaid] unnecessarily, causing problems for families and providers," said Tom Shanahan, spokesman for the department. He said the change also cuts down on administrative costs.

Idaho is one of two dozen states that have not expanded Medicaid. Idaho has stringent rules for Medicaid eligibility. For the most part, the state's Medicaid rolls are made up of impoverished children and pregnant women and people with disabilities. The expansion would add childless adults who are in poverty.

The Affordable Care Act required states to offer Medicaid to almost everyone under, or just above, the poverty line. But the U.S. Supreme Court said that requirement went too far and deemed Medicaid expansion optional.

But even without Idaho expanding its program, experts predicted a surge in Medicaid enrollment. A report prepared for the Idaho Department of Health and Welfare by Milliman Inc. predicted that more than 35,000 people would join Medicaid when they learned they already qualified for it. That was known as the "woodwork" group, for eligible people coming out of the woodwork.

The report said the cost of new enrollment — aside from the expansion — would total about $14.8 million in this fiscal year, then rise to between $32 million and $45 million per year over the next decade. That's not quite what happened, at least in these early months, Shanahan said.

"We just haven't seen the large increases we had expected," he said. Only about 35 percent — 5,000 people — of new Medicaid members are from the "woodwork" group, he said.

"Even looking at the enrollments coming from the federal marketplace [which processed Idaho's health-exchange applications], there are not many 'newly' eligible individuals who have not been on Medicaid in the past," Shanahan said.

The higher enrollment hasn't translated into much higher spending, at least when it comes to medical costs. Medicaid claims for Medicaid totaled about $796 million in the five months ending March 31, about a $1 million increase year-over-year.

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