Wednesday, August 05, 2020

In a devilish pandemic, Medicaid expansion is Utah's cave up in the hills

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In 2018, voters in Utah passed a referendum to enact the ACA Medicaid expansion, which would make Medicaid available to adults with incomes up to 138% of the Federal Poverty Level. Utah's Republican legislature and governor writhed, twisted, and enacted a partial expansion, to 100% FPL, effective in April 2019. When the federal government rejected a waiver to apply the ACA's 90% federal match rate to that limited expansion population, the state went to Plan B -- full expansion -- effective Jan 1, 2020. A work requirement was suspended in April 2020 in response to the pandemic.

Good timing. As the pandemic struck, jobless claims in Utah rose from 40,500 in February to 166,300 in April before falling back to 85,700 in June. The unemployment rate went from 2.5% to a peak of 10.4% in April to 5.1% in June. Medicaid enrollment responded:


Medicaid Enrollment in Utah, February--June 2020 

Enrollment category
  Feb
  March
  April
  May
  June
 Feb-   June   % change
 Feb-   June   raw   change
Medicaid/CHIP
309,766
310,476
325,923
332,574
343,375
10.8%
33,615
ACA expansion
47,948
50,134
54,061
57,026
59,589
24.2%
12,091

 Source: Utah Dept. of Health

In April, when the unemployed population in the state rose by 104,000, Medicaid enrollment rose 15,456. By June, when unemployment was 45,000 above the February level, Medicaid enrollment had increased by 33,609 over the February total. That's responsive!

To step back, in March 2019, a month prior to Utah's first-wave Medicaid expansion, total Medicaid/CHIP enrollment was 282,549. Through June 2020, enrollment had increased by 60,826, or 21.5% from that point.

In 2018, 10% of Utah's population under age 65 was uninsured (not bad for a non-expansion state). In a population of 3.3 million, or 2.8 million under 65, that translates to about 280,000 uninsured. It's likely that Medicaid expansion has significantly blunted increases in the uninsured during the pandemic.

See also: Medicaid enrollment in a pandemic: 18-state snapshot

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Photo by Brady Knoll from Pexels

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