Uh Oh: Are The Exchanges Goosing State Medicaid Rolls?

With the failings of the Affordable Care Act (ACA) as a backdrop, the Missouri House Interim Committee on Medicaid Transformation met over the last two days to discuss whether the state should expand Medicaid under that very law. Much of the media’s focus so far has been on the abject failure of the ACA’s website, but for those who have logged onto an insurance exchange successfully, often it’s not private insurance they’re coming away with — it’s Medicaid. [Emphasis mine.]

The disastrous rollout of HealthCare.gov may have another serious problem: A CBS News analysis shows that in many of the 15 state-based health insurance exchanges more people are enrolling in Medicaid rather than buying private health insurance. And if that trend continues, there’s concern there won’t be enough healthy people buying health insurance for the system to work….

CBS News has confirmed that in Washington, of the more than 35,000 people newly enrolled, 87 percent signed up for Medicaid. In Kentucky, out of 26,000 new enrollments, 82 percent are in Medicaid. And in New York, of 37,000 enrollments, Medicaid accounts for 64 percent. And there are similar stories across the country in nearly half of the states that run their own exchanges.

So the exchanges, billed as a private market solution to America’s health care problems, appear to be putting more people into a long-broken government program than into private insurance. That’s a huge contradiction in policy and puffery that undercuts the entire law. What assurances do taxpayers have that individuals aren’t being improperly added to the Medicaid program? And why would any legislature expand Medicaid just as Obamacare is boosting the program’s cost to the states?