Truven Health Analytics Shares Medicaid Expansion Estimates at National Association of Medicaid Directors (NAMD) Conference

Depending on states’ ACA participation, Medicaid could grow by up to 15 million members by 2016.

Since the June 28^th Supreme Court decision on the Patient Protection and Affordable Care Act (ACA), states have been planning for Health Insurance Exchanges and evaluating the option to expand Medicaid coverage to low income adults.  Whether to project future costs or plan for coverage expansion, states have been seeking to quantify and profile the newly eligible and likely to enroll populations. 

Based on recent simulations that estimate the proportion of states that will opt out of Medicaid expansion, Truven Health estimates that Medicaid will add 6 million members nationally by 2016.  Under this partial opt-in scenario, Medicaid enrollment grows from 47 to 53 million and exchange enrollment to 21 million.  If all states choose Medicaid expansion (full opt-in), Medicaid would grow to 62 million.

The newly insured population is geographically varied. 

There is great geographic variability in the size of the newly insured population.  States with more stringent Medicaid eligibility requirements and higher rates of uninsured will tend to see larger increases in the insured population due to the ACA.  Moreover, the insured population growth is not uniform within states or within specific metropolitan areas:  variation in small areas is pronounced.  Geographic estimates of insured population growth in small areas can assist government, health plans, and providers in planning for care of the newly insured.

You can learn more about Medicaid Expansion by visiting bit.ly/coverageestimates