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HPIO releases latest policy brief: Medicaid Enrollment Trends and Impact Analysis

Dear Janet,

The Health Policy Institute of Ohio has released its latest policy brief, “Medicaid enrollment trends and 
impact analysis
.” (pdf, 24 pages). 

A follow-up to the 2013 Medicaid Expansion Study conducted by HPIO, the Ohio State University and Urban Institute, the new policy brief examines enrollment trends after the first year of Medicaid expansion, including analysis of enrollment in all Ohio counties. 

As part of the budget process next year, Ohio policymakers will have to decide whether to approve funding to maintain Medicaid eligibility at current levels. To assist with the decision-making process, HPIO, in partnership with the Ohio State University and with funding from AARP Ohio, the Mt. Sinai Health Care Foundation, Interact for Health and the George Gund Foundation, compiled this analysis. 

The analysis uses data such as Medicaid enrollment and caseload reports, Census data, predictive modeling, literature review and stakeholder interviews to:

  • Examine the early impacts of Medicaid expansion on enrollment trends
  • Compare these enrollment trends to estimated projections made as a part of the 2013 Ohio Medicaid Expansion Study by OSU and the Urban Institute
  • Present additional estimates using actual enrollment as the base
  • Analyze literature relevant to the impact of Medicaid on the health and well-being of Ohioans
  • Explore the impact of Medicaid eligibility changes from the perspective of key stakeholders

Key points include:

  • Medicaid enrollment in the Medicaid extension category (adults 19-64 with incomes below 138% of the Federal Poverty Level) reached 430,998 Ohioans through the end of October 2014.  This is 6.1% of 19 to 64 year old Ohioans.  Note that distribution by county is included in Appendix A.
  • For half of state fiscal year 2014 (Jan-June 2014), the OSU and UI projections were less than actual results.  For calendar year 2014, it appears that the OSU estimate will be slightly above actual (106 percent of actual) while the UI estimates will be below actual.
  • The re-based projections created by OSU are higher than the 2013 projections, due to  a number of factors, including the fact that the open enrollment surge was greater than originally anticipated.  The re-based projections are compared to the original projections to provide a new range of potential enrollment growth.  The analysis shows a Medicaid extension enrollment range between 642,357 and 703,667 by the end of SFY 2017.
  • The literature review and implications for future study point to opportunities for future state-specific research and analysis to determine the impact of broadened Medicaid eligibility on the health and well-being of Ohioans.
  • Key stakeholders are supportive of the new Medicaid eligibility levels, agreeing that this policy change has reduced the number of uninsured in Ohio.  Challenges include exploring models of payment reimbursement reform, ensuring adequate payments to providers, and increasing the number of primary care providers.


Source: Health Policy Institute of Ohio

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