VA sees plenty of new Medicaid enrollees even without expansion

By Kathryn Watson | Watchdog.org, Virginia Bureau

ALEXANDRIA, Va. — Virginia hasn’t expanded Medicaid under the Affordable Care Act, but that hasn’t kept new enrollment figures from steadily climbing since October, when the health care law kicked in.

ACA Signups.net, which aggregates data on enrollment figures, is reporting 27,860 new enrollees (not renewals) in Virginia for the months of October, November, December and January — the majority coming in the last two months.

Sure, that’s nothing like California, where Medicaid expansion encouraged 1.5 million new people to enroll, but expansion or not, Virginia is continuing to take on new Medicaid beneficiaries. The state spends about $4 billion annually already on its roughly 1 million Medicaid recipients. That is expected to increase to nearly $6 billion in fiscal year 2016, according to a forecast from the Department of Planning and Budget.

“With or without expansion Medicaid is going to still be the top budget item or the second to top budget item for most states,” said Yevgeniy Feyman, a health care policy fellow with the Manhattan Institute. “In Virginia, it’s probably not going to be any different.”

Some of those enrollees are due to the “woodwork effect, as it’s called,” Feyman said.

People who already qualified for Medicaid are signing up for health care because of the increased awareness and the individual mandate penalty. Still, many who qualify for Medicaid don’t earn enough to be pinged by the mandate’s fine, so there isn’t as much of an incentive to sign up.

Virginia’s Department of Medical Assistance Services didn’t have readily available figures on new enrollees historically.

Virginia Medicaid enrollment has climbed in the recent years of the Great Recession, with enrollment jumping from 519,735 in 2003 to 1,043,330 two decades later in 2013, according to figures from Virginia’s DMAS. That growth isn’t expected to reverse course in the future. The Urban Institute and Kaiser Family Foundation have estimated conservatively that, even without expansion, Virginia will add about 80,000 more individuals to the program by 2022.

In the days ahead, state senators and delegates will come together with their two versions of a budget bill — one that includes a form of Medicaid expansion and one that does not. It’s a battle that may be over in less than two weeks — or, with a budget impasse, the matter could be dragged out into summer.

— Kathryn Watson is a reporter for Watchdog.org, and can be reached at kwatson@watchdog.org.

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