If the present trend continues the most significant result of the PPACA will be its expansion of Medicaid:
Federal health officials announced on Wednesday that some 1.2 million people selected plans on federal or state exchanges during the months of October and November. That included 803,000 people who applied to the exchanges and were found eligible for Medicaid or a related Children’s Health Insurance Program that provide public insurance for the poor — in addition to nearly 365,000 people who chose private plans.
Outside the exchanges, there has also been an increase in applications sent directly to state agencies that run Medicaid and CHIP. Applications were up 15.5 percent in October in states that are expanding their Medicaid programs and up 4.1 percent in states that are not.
Roughly a third of those enrolling newly for Medicaid were eligible under the old rules which means the federal government won’t be picking up the tab for them as it is for enrollments only possible under the new rules for eligibility in states that have elected to expand Medicaid under the PPACA. Medicaid alreadys accounts for about a quarter of states’ budgets.
States are already hard-pressed to pay their Medicaid bills. In Illinois, for example, it can take as much as a year for the state to pay providers under Medicaid.
I wonder how the states will get the money to pay these new bills? Increasing nominal rates is hard enough but increasing actual revenues is even harder.
There’s an old saying, “All dressed up and no where to go,” that could be reworked for the PPACA — “A program creating 15,000 pages of rules and regulations, making little sense and in which few want to participate in.”