COVID-19

States scrambling with Medicaid enrollments climbing

Erika Beras Nov 30, 2020
Heard on: Marketplace
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Medical workers walk outside of a special coronavirus intake area at hospital in Brooklyn earlier this year. Spencer Platt/Getty Images
COVID-19

States scrambling with Medicaid enrollments climbing

Erika Beras Nov 30, 2020
Medical workers walk outside of a special coronavirus intake area at hospital in Brooklyn earlier this year. Spencer Platt/Getty Images
HTML EMBED:
COPY

As this pandemic stretches on and on, one health care plan that’s been gaining enrollees all year is Medicaid.

The federal and state program helps with medical costs for children, disabled people and those with low-incomes. This year’s increase in Medicaid enrollments may mean financial trouble for states. Some may need to start looking for ways to cut Medicaid costs without cutting the Medicaid program.

As millions of people have lost their jobs in this pandemic, many have also lost their health insurance.

“Medicaid has really been a first responder in the COVID-19 pandemic, both from a health perspective and an economic perspective,” said Joan Alker, executive director of the Center for Children and Families at Georgetown University.

As of July, some 4 million more people enrolled in Medicaid than were on the rolls in February, and that number keep growing. With all those new enrollees comes added expense.

For most states, Medicaid makes up around one-third of the state budget.

With less income tax coming in, less sales revenue and a slew of unexpected pandemic expenses, states are strapped.

“Governors are working on putting together budgets for the upcoming 2022 fiscal year, which begins July 1. And they will have to assume that fiscal relief is not available,” said Robin Rudowitz with the Kaiser Family Foundation.

The federal government typically matches state expenditures 50/50. But for people who got Medicaid through the Affordable Care Act expansion, the government covers 90%. States also got extra federal money for Medicaid through the CARES Act in the spring.

Sara Rosenbaum, a health law and policy professor at George Washington University, said states are looking for any place they can trim.

“Probably the No. 1 thing states are strategizing around is cutting provider payments or deferring provider payments in order to free up money,” she said. Or eliminating health benefits, like dental or vision.

James Nash of the National Governors Association said if states can’t make more trims in Medicaid, other vital services could be cut.

“We’re talking about K-12 and higher education. We’re talking about corrections and public safety,” he said.

So states are doing some hard math.

COVID-19 Economy FAQs

With a slow vaccine rollout so far, how has the government changed its approach?

On Tuesday, Jan. 12, Health and Human Services Secretary Alex Azar announced changes to how the federal government is distributing vaccine doses. The CDC has expanded coronavirus vaccine eligibility to everyone 65 and older, along with people with conditions that might raise their risks of complications from COVID-19. The new approach also looks to reward those states that are the most efficient by giving them more doses, but critics say that won’t address underlying problems some states are having with vaccine rollout.

What kind of help can small businesses get right now?

A new round of Paycheck Protection Program loans recently became available for pandemic-ravaged businesses. These loans don’t have to be paid back if rules are met. Right now, loans are open for first-time applicants. And the application has to go through community banking organizations — no big banks, for now, at least. This rollout is designed to help business owners who couldn’t get a PPP loan before.

What does the hiring situation in the U.S. look like as we enter the new year?

New data on job openings and postings provide a glimpse of what to expect in the job market in the coming weeks and months. This time of year typically sees a spike in hiring and job-search activity, says Jill Chapman with Insperity, a recruiting services firm. But that kind of optimistic planning for the future isn’t really the vibe these days. Job postings have been lagging on the job search site Indeed. Listings were down about 11% in December compared to a year earlier.

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