Studies Show Uncertainty in Medicaid Enrollment, as ACA Would Cover Millions Without Individual Mandate - November 1, 2011

A study published in October’s edition of Health Affairs estimates that 23 million people would still gain coverage under the Affordable Care Act (ACA) even if the Supreme Court finds the individual mandate unconstitutional. The authors – The Lewin Group’s John Sheils and Randall Haught – also estimate that premiums in the individual market would increase if the mandate was struck but other provisions regulating insurers remained in the ACA. According to their findings, which were determined using economic models, the individual mandate might not be essential to successful implementation of the ACA.

In the same Health Affairs issue, a team from the Harvard School of Public Health released a study warning states to prepare for the unexpected regarding Medicaid enrollment. With anywhere from 8.5 million to almost 23 million people newly eligible for Medicaid under the ACA, it is unclear how many of them will enroll in the program. This uncertainty poses a challenge to states – particularly with respect to budget planning and ensuring access to care. The study also noted that the extent to which people enroll in Medicaid will largely depend on state and federal efforts to encourage or discourage enrollment.