Focus on Health System Reform: The Cost of Medicaid Expansion in NC

The NCMS provided information last year regarding the financial impact of the Affordable Care Act’s Medicaid expansion in North Carolina (read “Expanding Role of Medicaid, Bulletin, 8-20-10).  This week we’d like to update those numbers to provide a clearer sense of the budgetary impacts of the Medicaid expansion to occur between the years of 2014 and 2019.

  • New NC Medicaid Enrollees by 2019: 633,485 – 877,560 depending on outreach efforts of state and federal government.
  • Previously uninsured, newly enrolled in Medicaid by 2019: 429,272 – 661,292 depending on outreach efforts of state and federal government. Costing state $811 million  – $932 million.
  • Total State expenditures on expansion: $ 1 billion – $1.8 billion.

Source: Kaiser Commission on Medicaid and the Uninsured

Changes have been implemented in the Medicaid program in 2011:

  • States will now have the option to permit certain Medicaid enrollees to designate a provider as their health home. States will receive 90% FMAP for 2 years for these services.
  • Health and Human Services can begin providing 3 year grants to states to develop chronic disease prevention programs under Medicaid.
  • Prohibition on federal payments to states for Medicaid services related to certain hospital-acquired infections.
  • State balancing incentive program created to provide enhanced FMAP payments for non-institutionally based long-term care services.

Be watching for more updates, particularly on state funding for Medicaid. When the General Assembly convenes next week, legislators are expected to take a close look at spending in order to address a multi-billion dollar shortfall.  Medicaid and education make up the largest portion of the state budget.


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