New Medicaid enrollments dwarf exchanges

While enrollments trickle in for Connect for Health Colorado, the state’s Medicaid expansion has seen enrollments 10 times that of the health-care exchange, thanks in part to a special program that launched last year.
Both the exchange and the Medicaid expansion began open enrollment Oct. 1, but Connect for Health Colorado has enrolled 3,408 people compared with 34,168 new Medicaid enrollees under the expanded Medicaid eligibility requirements.
Under the Patient Protection and Affordable Care Act, states were given the opportunity to expand their Medicaid eligibility using federal funds.
The Affordable Care Act authorizes new coverage levels beginning Jan 1 that will allow Coloradans earning up to 133 percent of the federal poverty level – $14,856 for an individual and $30,657 for a family of four – to enroll in Medicaid.
Colorado law already allows Medicaid to cover children and some adults in this income bracket. The new eligibility standards will enable the state to cover an additional 160,000 adults. Medicaid currently covers about 620,000 people in Colorado.
The federal government will cover 100 percent of the costs for the newly eligible Medicaid population through 2016. In 2017, the federal match rates will begin to shrink. By 2020, Colorado will be responsible for 10 percent of the costs.
The expansion would cost Colorado $128 million over the next 10 years, according to an estimate by the state earlier this year. In January, Gov. John Hickenlooper announced that Colorado hopes to find $280 million in Medicaid cost savings over the next 10 years so that it can afford to enroll tens of thousands of newly eligible people.
The $280 million is expected to come from efforts by the Department of Health Care Policy and Financing to control Medicaid costs in a number of areas.
Open enrollment under the expanded requirements has been under way for just six weeks, but the Department of Health Care Policy and Financing has been enrolling participants in a program called Adults without Dependent Children since June 2012, according to Sue Birch, executive director of the department.
The Adults without Dependent Children, or “AwDC” program was launched to enable adults earning from zero to 10 percent of the federal poverty level but who don’t have children to enroll in Medicaid. Previously, Medicaid was limited to children, pregnant women, people with disabilities and the elderly.
The Affordable Care Act made it possible for states to get matching funds to help cover adults without children as long as the state puts up a portion of the money as well. In Colorado, this money comes from a hospital provider fee assessed on all inpatient days and outpatient charges, said Rachel Reiter, spokeswoman for the Department of Health Care Policy and Financing.
Clinics and emergency rooms also have helped identify those who may be eligible. More than 20,000 already are enrolled in AwDC, with more than 9,000 on the waiting list.
Also helping the enrollment process for Medicaid is the Patient Enrollment Application Process, or PEAK, according to Birch. PEAK is a website that allows for streamlined application and enrollment that potential Medicaid recipients can access on their own. PEAK also helps people enroll in the Supplemental Nutrition Assistance Program and other government programs, but beginning Oct. 1, it began allowing Medicaid enrollment under the new eligibility requirements.
The system allows people to determine almost immediately if they qualify for Medicaid, something consumer advocates applaud.
“We’re pleased that the enrollment process has begun and that the system can tell people if they qualify or not quickly, so that they can move on to the exchange if necessary,” said Elisabeth Arenales, director of the health program at the Colorado Center on Law and Policy.
“The opportunity for people to be enrolled for the first time is extraordinary,” Arenales said. “The state can reap benefits both fiscally and socially.”
In February, the Colorado Health Foundation released a study showing that as many as 22,000 jobs could be created in Colorado as a result of Medicaid expansion and would provide a $4.4 billion boost to the state’s economy over the next 13 years.
Most of these jobs are predicted to be created in the medical sector, with more doctors, nurses and other practitioners needed to care for expanded populations of insured Coloradans.

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Molly Armbrister covers real estate, banking and health care for the Northern Colorado Business Report. She can be reached at 970-232-3139, marmbrister@ncbr.com or twitter.com/MArmbristerNCBR
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