Virginia Medicaid expansion breaks 233K, 67K shifted from ACA plans?
When I last checked in to see how Virginia's newly-enacted ACA Medicaid expansion program was doing, they had already enrolled around half of the 400,000 estimated residents eligible to do so statewide.
Last fall, I estimated that perhaps 85,000 of those newly eligible to enroll in Medicaid would actually be "cannibalized" from the existing ACA exchange enrollee population...and sure enough, when the 2019 Open Enrollment numbers were posted, exhange enrollment in Virginia was down by 72,000 people, putting them dead last nationally in terms of year over year performance (down 18% from 2018).
Unfortunately, without an income demographic breakout, there's no way of being certain how much of that dropoff was due to Medicaid expansion as opposed to middle-income enrollees simply choosing to drop their coverage.
Today, however, Virginia state delegate Danica Roem posted the following update, which includes a link to a very nifty interactive graphic Medicaid expansion dashboard:
As we complete the second full month of Medicaid expansion enrollment in Virginia, 233,179 more Virginians now have quality, affordable health insurance.
That includes 9,107 Prince William County residents & 331 Manassas Park residents.
— Danica Roem (@pwcdanica) February 28, 2019
The dashboard itself breaks out current Medicaid expansion data in a number of ways, including by county, gender, age, region...and even family income level. They've wisely separated it into those earning less than 100% of the Federal Poverty Line (166,000) and those earning between 100-138% FPL (67,300). The second group are the ones who would have been enrolled in heavily subsidized ACA exchange policies until the end of 2018.
Again, I doubt that all 67.3K enrollees dropped their ACA plans--some of them were probably uninsured at all, or had their circumstances change recently--but the odds are good that the vast bulk fo them did so. 67.3K vs. 72K is a pretty close matchup. My 85K estimate might have proven to be too high, but it was still in the ballpark.