...in spite of nearly every state which tried to (or succeeded in) implement Medicaid work requirements having their programs shut down by the courts, one state's work/reporting managed to survive: Georgia. As explained in the Kaiser article:
As for when the program would actually go into effect, however...that's been something of a mystery for awhile now. Apparently the wording of the legislation ties it in with it being included in the general state budget, which hasn't happened yet. As a result, no one seems to be sure whether NC Medicaid expansion will kick off in October, November, December or January of next year.
"Work requirements" is as old a saw for Republican politicians as "selling insurance across state lines," and it's just as ineffective and counterproductive (as well as simply being cruel). This debate has been held numerous times before, and the upside of such requirements has been debunked repeatedly, but here he go again:
SIOUX FALLS, S.D. (Dakota News Now) - Although Medicaid expansion in the state of South Dakota doesn’t take effect for another month, the window to apply opened on Thursday. A kickoff event was held for advocates and patients to review the benefits for those who qualify.
“Today has been long overdue. No one should have to choose between bankrupting their family and getting the health coverage they need,” said Dr. Dan Johnson from the American Cancer Society.
After the hard work of gathering petition signatures and talking to voters, Medicaid expansion advocates are celebrating enrollment opening for South Dakota residents.
...Over 50,000 people will be eligible for Medicaid, as voters approved Constitutional Amendment D last November. Erik Nelson, an advocate with AARP, has had positive conversations with the state handling the logistics of enrollment.
...Even if applicants don’t have their application completed by the July 1 effective date, a plan is in place.
Back in January, as the 2023 Open Enrollment Period wound down, I posted a colorful graph which tracked ACA Qualified Health Plan (QHP) enrollment over ten years of Open Enrollment Periods.
Today I'm doing the same thing for ACA Medicaid Expansion. The data comes from the Centers for Medicare & Medicaid Services monthly Medicaid Budget & Expenditure System reports.
Also keep in mind that if the remaining 10 states had expanded Medicaid under the ACA by now, the grand total would have been up to 3.5 million higher (around 27.9 million nationally).
Aside from various holdout states jumping in as the years have passed, the most notable milestone was the month that the COVID pandemic hit the U.S. in full force, shutting businesses down across the country in March 2020.
No further analysis or comment here; I just think this is a pretty cool graphic...and keep in mind that most of the ~23.5 million people represented here (again, likely over 24M today) would have been utterly screwed 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:
For this, I'm assuming a similar 94% average effectuation rate as of February 1st (2 days from now) to the ASPE report from last year for QHP enrollees. Taken literally, that would mean 15,328,061 effectuated on-exchange ACA enrollees.
Back in late January, I crunched the numbers on the total number of Americans who currently have healthcare coverage directly via the Affordable Care Act. This includes three categories: Exchange-based Qualified Health Plans (QHPs); the Basic Health Plan (BHP) progams in Minnesota and New York; and Medicaid Expansion in the 38 states (+DC) which had implemented it as of that point.
I concluded that the total numbers for each were roughly 15.4 million QHPs, 1.2 million BHPs and 23.5 million Medicaid expansion enrollees, or around 40.1 million people total.
Earlier this week, the Centers for Medicare & Medicaid Services (CMS) confirmed my estimates and even came in slightly higher, at around 40.2 million. They put effectuated QHPs at 15.6 million and Medicaid expansion enrollment at around 23.4 million.
As I noted at the time, Vought's proposed budget would include, among many other horrific things, completely eliminating funding for the ACA's Medicaid expansion program as well as complete elimination of all Advance Premium Tax Credit (APTC) funding for ACA exchange-based individual market enrollees.
I went on to note that if this proposal were to somehow pass the Senate and be signed into law by President Biden (neither of which is likely to happen, to put it mildly), nearly 40 million Americans would lose healthcare coverage as a result nationally.
Below, I've broken that number out by state to give better context about just how draconian such an eventuality would be.
UPDATE 3/15/23: The agreed-to Medicaid expansion deal has passed the NC State Senate! It now just needs to pass the state House one final time and then it's on to Gov. Cooper's desk to be signed into law!
RALEIGH, N.C. (AP) — The North Carolina General Assembly began on Tuesday what could become the final push to expand Medicaid to hundreds of thousands of low-income adults in the state with a House measure that quickly advanced through two committees with bipartisan support.
The bill is generally expected to pass the NC House as soon as today...and a different version of the bill is expected to pass the state Senate as well. The issue is the difference between the two versions:
