The experiences of the six states that expanded Medicaid in the years just before the 2014 start of the Affordable Care Act show that costs are hard to predict and new beneficiaries likely suffer from untreated mental health or substance abuse issues, according to a new report.
Since the passage of President Obama's health care overhaul in 2010, five states and Washington, D.C., have expanded coverage to some or all of the low-income population that the federal government will cover completely before phasing down support to 90 percent. All of them—California, Connecticut, Minnesota, New Jersey and Washington state—cover childless adults at varying levels, from 23 percent of the federal poverty line in New Jersey to 200 percent in some California counties. The federal government will cut off expansion coverage at 138 percent of the federal poverty line under the latest eligibility system starting 2014.
Interviews with Medicaid officials in those states formed the basis of the study from the Urban Institute and the Harvard School of Public Health. The report was recently published in the Medicare and Medicaid Research Review, a publication of the Centers for Medicare and Medicaid Services.