Medicaid expansion has had varying effects on enrollment across CSG/ERC states. Under the Affordable Care Act, as of January 1, 2014 states have the option to expand Medicaid eligibility for all low-income Americans, regardless of age or family circumstances. Federal funds will reimburse states for all the costs of care for newly eligible members through next year. The reimbursement rate then tapers down to 90% in 2020 where it will remain permanently, far above the reimbursement rate for most Medicaid members. All ERC states but Maine have elected to expand coverage so far but with varied implementation dates. According to the latest CMS report, all CSG/ERC states that reported have seen an increase in Medicaid enrollment since before the ACA, but the rise varies considerably from Pennsylvania with only a 6.4% increase so far to Rhode Island with a 42% increase. Nationally enrollment growth averaged 28% for states that chose to expand Medicaid, and 8.6% for those that haven’t expanded.
State | Expanding Medicaid? | Total Medicaid enrollmentMarch 2015 | % change July-Sept 2013 to March 2015 |
CT | Yes | 726,253 | Not reported |
DE | Yes | 238,621 | 6.9% |
MD | Yes | 1,182,067 | 38.0% |
MA | Yes | 1,692,477 | 30.6% |
ME | No | 284,206 | Not reported |
NH | Yes | 174,908 | 37.6% |
NJ | Yes | 1,699,114 | 32.4% |
NY | Yes | 6,398,893 | 12.7% |
PA | Yes | 2,539,514 | 6.4% |
RI | Yes | 271,524 | 42.3% |
VT | Yes | 183,618 | 14.0% |
US average for expanding states | 28.1% | ||
US average for non-expansion states | 8.6% |