“The national estimate for the cost of Medicaid expansion is based current enrollees,” said study co-author Dr. Tammy Chang. “Our study shows that likely the newer enrollees are going to have less chronic disease, and so providing healthcare may have lower than expected costs.”
The findings showed higher rates of smoking and alcohol consumption among newly eligible enrollees compared with current Medicaid recipients.
But Chang said the Medicaid expansion will give healthcare professionals an opportunity to work with new Medicaid beneficiaries on changing their behavior before serious medical conditions develop. “As a family physician we see a lot of complicated Medicaid patients,” Chang said. “It would be wonderful to have newly eligible Medicaid patients who are healthy now but maybe have some health behaviors we can work on.”
Nearly half the states have refused to expand their Medicaid programs to adults earning up to 138% of the federal poverty level as authorized by the Patient Protection and Affordable Care Act. Republican leaders in those states have argued have contended the expansion would be too expensive for their states, even though the federal government would pay 100% of the cost of the expansion for the first three years and 90% after that.
But the study, which used data collected from the National Health and Nutrition Examination Survey, suggests the costs of providing health coverage for the millions expected to be added to the program may not be as high as previously projected.
A 2012 study by the Kaiser Family Foundation estimated the Medicaid expansion would increase total state spending on the program by $76 billion through 2022. The Congressional Budget Office projects 13 million people will become eligible for Medicaid by 2022.
If new Medicaid members are younger and healthier, that could change how healthcare providers view serving Medicaid patients, because they would be less costly and time-consuming to care for, she said.