Health Care

Obamacare Medicaid Expansion Enrollment Is Shattering Projections

January 1, 2017

Jonathan Ingram, Nicholas Horton

In April 2015, the Foundation for Government Accountability released a study highlighting Obamacare expansion’s enrollment explosion, using data from the first year of expansion. Now, new research finds the situation has only gotten worse.

Enrollment in previously reviewed states has blasted further past projected maximums, and new data from additional expansion states indicate the problem is even worse than previously known. Altogether, 24 states that accepted Obamacare’s expansion released enrollment projections in advance and have since reported at least one year of enrollment data.

In total, these 24 states promised that “only” 5.5 million adults would ever sign up for Obamacare expansion. However, actual sign-ups have surpassed these projections—and not just by a little bit. Newly obtained data from these 24 states show that at least 11.5 million able-bodied adults have now enrolled in Obamacare expansion—an overrun of 110 percent, or more than double projections. Some states have signed up more than four times as many able-bodied adults as they said would ever enroll.

This enrollment explosion will soon unleash a fiscal crisis. Unlike the federal government, states cannot print their own money, and, starting in January 2017, states’ share of Medicaid expansion costs will increase to five percent. Assuming the federal government keeps its funding promises—which is in question—state costs will gradually rise to 10 percent by 2020. With expansion enrollment and per-enrollee costs rising higher and faster than Obamacare advocates promised, those costs will rapidly swamp state budgets.

Medicaid expansion already makes welfare for able-bodied adults a higher priority than services for the nearly 600,000 seniors, children with developmental disabilities, individuals with brain injuries, and other vulnerable individuals currently languishing on waiting lists for needed Medicaid services. Mounting overruns will soon exacerbate pressure on policymakers to shift even more money away from the truly needy and towards Obamacare’s able-bodied adults.

Obamacare expansion’s enrollment explosion, combined with higher-than-expected costs for able-bodied adults, will spell disaster for Obamacare expansion states, taking limited taxpayer resources away from the truly needy and from other core priorities, including education, public safety, and infrastructure.

Policymakers in non-expansion states like Oklahoma should take notice of the disasters unfolding in states that have embraced Obamacare and be glad that they have protected their own states from the same fate.

Jonathan Ingram is vice president of research at the Foundation for Government Accountability, a nonprofit think tank which equips policymakers with principled strategies to replace failed health and welfare programs. He is co-author, with OCPA president Jonathan Small, of the April 2016 report, “Out of Balance: Oklahoma Health Care Authority’s Latest Plan Is Simply Obamacare Medicaid Expansion by Another Name.”

Nicholas Horton is a senior research fellow at the Foundation for Government Accountability.