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  DECEMBER 10, 2010
PUBLIC HEALTH RESEARCH AND REPORTS
Can Medicaid Successfully Enroll the Uninsured?

The broad expansion of Medicaid to cover all adults whose family income is below 133 percent of the federal poverty line is one of two strategies that the Patient Protection and Affordable Care Act calls for to expand health insurance coverage in the United States. Predicting the success of that strategy, however, is not as simple as it appears, according to Harvard School of Public Health’s Dr. Benjamin Sommers, assistant professor of health policy and economics, and Dr. Arnold Epstein, chair of the department of health policy. 

In a recent article in the New England Journal of Medicine, Drs. Sommers and Epstein write that eligibility for health insurance will not necessarily translate into actual enrollment.

Estimates from the Congressional Budget Office suggest that the Medicaid expansion will add 16 million enrollees. Citing the wide variability of current enrollment in Medicaid, the authors estimate that, to achieve that number, participation rates among all newly eligible individuals who are not privately insured would need to be nearly 80 percent, much higher than the current take-up rate among eligible adults of 61.7 percent.

The good news is that the expansion of Medicaid will not take place until 2014, so the government has time to work on its enrollment efforts. The authors note that Massachusetts was able to achieve a take-up rate of 80 percent after implementing a law that requires residents to purchase health insurance.

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