Medicaid Expansion

Last month I noted that North Carolina's ACA Medicaid expansion initiative, which started in December 2023, had officially enrolled more than 400,000 of the estimated 600,000 NC residents eligible for the program.

I just checked on the official NC Dept. of Health & Human Services Medicaid expansion dashboard, and it says that as of May 3rd, expansion enrollment there was up to 447,498 people.

It will be interesting to see how close to that 600K estimate enrollment ends up being over the next year or so.

Back in February I posted a colorful graph which showed the progress of ACA Medicaid Expansion from January 2014 through June 2023.

The data comes from the Centers for Medicare & Medicaid Services quarterly Medicaid Budget & Expenditure System reports. Unfortunately, the MBES reports only ran through June of last year, so it was missing the last half of the year...which is pretty important since that's when the drop in Medicaid coverage due to the ongoing Unwinding process really started to kick in.

Fortunately, CMS recently updated the MBES data to include the third quarter of 2023, bringing Medicaid enrollment *up through September. It's still 8 months out of date but it's better than nothing.

Note: Medicaid expansion enrollment actually peaked in May 2023 at just shy of 24.8 million, but the graph below only includes 6-month increments (January/June).

As of September 2023, MBES put Medicaid expansion enrollment at 23,225,220 nationally.

No further analysis or comment here; I just think this is a pretty cool graphic...and keep in mind that most of the people represented here would have been utterly screwed from early 2020 - early 2023 without the Affordable Care Act being in place when the pandemic hit.

Click the image for a higher-resolution version; the states are listed on the right-hand side, though they might be difficult to make out (also note that Guam, Puerto Rico and the U.S. Virgin Islands also have a number of ACA expansion enrollees shown):

February 16th:

I strongly suspect that at least one of the remaining holdout states will join the expansion crowd this year, most likely Georgia, Mississippi or Alabama...but it likely will be some state-specific variant as described above. Stay tuned...

...As I noted, however, in all three [states] it's pretty likely they'll go with at least a partially privatized version as Arkansas has instead of a "clean" expansion of Medicaid proper.

February 28th:

BREAKING: The Mississippi House just passed Medicaid expansion by a 96-20 vote.
That's more than enough to overcome a veto from Gov. Tate Reeves.
It now heads to the Senate.

Background: https://t.co/exDyzFAcJX

— Ashton Pittman (@ashtonpittman) February 28, 2024

February 16th:

I strongly suspect that at least one of the remaining holdout states will join the expansion crowd this year, most likely Georgia, Mississippi or Alabama...but it likely will be some state-specific variant as described above. Stay tuned...

...As I noted, however, in all three [states] it's pretty likely they'll go with at least a partially privatized version as Arkansas has instead of a "clean" expansion of Medicaid proper.

February 28th:

BREAKING: The Mississippi House just passed Medicaid expansion by a 96-20 vote.
That's more than enough to overcome a veto from Gov. Tate Reeves.
It now heads to the Senate.

Background: https://t.co/exDyzFAcJX

— Ashton Pittman (@ashtonpittman) February 28, 2024

From the linked article in Pittman's tweet:

via North Carolina Governor Roy Cooper:

Today, Governor Cooper announced that more than 400,000 North Carolinians now have access to health care through the state’s Medicaid expansion following record enrollment numbers and a coordinated campaign to enroll North Carolinians across the state.

“So many younger, working people desperately need affordable health insurance and Medicaid Expansion fills the bill for thousands of them and with people all the way through age 64,” said Governor Roy Cooper. “This milestone and the speed at which we’ve reached it shows just how lifechanging Medicaid expansion is for our state and we will continue to get more eligible North Carolinians enrolled.”

February 16th:

I strongly suspect that at least one of the remaining holdout states will join the expansion crowd this year, most likely Georgia, Mississippi or Alabama...but it likely will be some state-specific variant as described above. Stay tuned...

...As I noted, however, in all three [states] it's pretty likely they'll go with at least a partially privatized version as Arkansas has instead of a "clean" expansion of Medicaid proper.

Of course, as one Alabama-based advocate put it...

Mississippi better not beat us to expand.

— Jane Adams (@janeadamsid) February 16, 2024

Well, it looks like Ms. Adams may end up being disappointed...

BREAKING: The Mississippi House just passed Medicaid expansion by a 96-20 vote.
That's more than enough to overcome a veto from Gov. Tate Reeves.
It now heads to the Senate.

Two weeks ago:

As I concluded in the last piece:

I strongly suspect that at least one of the remaining holdout states will join the expansion crowd this year, most likely Georgia, Mississippi or Alabama...but it likely will be some state-specific variant as described above. Stay tuned...

...As I noted, however, in all three [states] it's pretty likely they'll go with at least a partially privatized version as Arkansas has instead of a "clean" expansion of Medicaid proper.

Of course, as one Alabama-based advocate put it...

Mississippi better not beat us to expand.

— Jane Adams (@janeadamsid) February 16, 2024

Well, it looks like Ms. Adams may end up being disappointed...

Just a week ago, I posted...

I strongly suspect that at least one of the remaining holdout states will join the expansion crowd this year, most likely Georgia, Mississippi or Alabama...but it likely will be some state-specific variant as described above. Stay tuned...

And just a few hours ago, I posted a piece headlined, "Which Holdout State Will Be Next To Finally Expand Medicaid??"

Well, it looks like we may have our answer already. Via Ashton Pittman of the Mississippi Free Press:

A Medicaid expansion bill will arrive in the Mississippi Senate by Monday, beginning a process that could provide health care to about 230,000 working Mississippians, Lt. Gov. Delbert Hosemann says.

via the North Carolina Dept. of Health & Human Services:

NC Medicaid Expansion Continues to Bring Health Care to More North Carolinians

PRESS RELEASE — As of Feb. 1, 2024, 346,408 newly eligible North Carolinians are enrolled in Medicaid and now have access to comprehensive health care, according to the North Carolina Department of Health and Human Services’ Medicaid Expansion Enrollment Dashboard. NCDHHS released an updated the dashboard today, and it includes enrollment data as of Feb. 1, 2024. This number is more than half of the anticipated 600,000 people who are newly eligible for coverage, expected to enroll in Medicaid expansion over the next two years.

"In the first two months we have already enrolled over half of the eligible people," said NC Health and Human Services Secretary Kody H. Kinsley. "These individuals and families are seeing providers, utilizing preventative and specialty care, and getting life-saving prescriptions."

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