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Policymakers should prepare for major uncertainties with Medicaid expansion
Date:10/26/2011

Boston, MA The number of low-income, uninsured Americans enrolling in Medicaid under the expanded coverage made possible by the Affordable Care Act (ACA) of 2010 could vary considerably from the levels currently projected by the Congressional Budget Office (CBO) and the Centers for Medicare and Medicaid Services (CMS), according to a new study by Harvard School of Public Health (HSPH) researchers. They report that it's probably more realistic to say somewhere between 8 million and 22 million may enroll in Medicaid by 2014 instead of the 16 million predicted by the CBO.

Medicaid, which is jointly funded by the federal and state governments, covers the health care costs of eligible low-income individuals and families. The Affordable Care Act of 2010 expands Medicaid to cover additional low-income adults in all states by 2014.

"The lower estimate of Medicaid enrollees suggests that the ACA will not be as successful as envisioned in insuring low-income Americans; the high-end estimate implies that the federal cost of expanding Medicaid eligibility will be a good deal higher than expected and accounted for," said Arnold Epstein, John H. Foster Professor of Health Policy and Management and chair, Department of Health Policy and Management at HSPH and the study's senior author.

The study was published online October 26, 2011, and will appear in the November print edition of Health Affairs.

The HSPH researchers, including lead author Benjamin Sommers, assistant professor of health policy and economics, and Katherine Swartz, professor of health economics and policy, created a simulation model to determine the range of reasonable projections, estimating eligibility, participation, and population growth using prior research and other data.

The researchers' model predicts that the number of people enrolling in Medicaid under health reform may vary by more than 10 million, with a "best-guess" estimate of 13.4 million,
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Contact: Marge Dwyer
mhdwyer@hsph.harvard.edu
617-432-8416
Harvard School of Public Health
Source:Eurekalert

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