Medicaid Expansion May Shift Beneficiary Pool

The expansion of Medicaid may drastically change the demographics of beneficiaries. With health reform, adults making up to 138% of the federal poverty level will be able to sign up for Medicaid under a federally paid expansion starting in 2014. This shift in regulations may result in a more diverse Medicaid population.

According to the recent study, which used statistics from the National Health and Nutrition Examination Survey, the new group of Medicaid beneficiaries are:

• About 36 years old on average, compared with about 39 years old for the current enrollees.
• Approximately 59% non-Hispanic white, compared with about 50% in the existing group.
• Equally split between males and females, compared with about 67% female and 33% male in the current Medicaid population.
• More likely to smoke and drink, but also more likely to have lower rates of obesity and diabetes.

Study author Dr Tammy Chang says while the new Medicaid enrollees will be healthier and less obese or depressed than the current population, there will also more will be smokers and drinkers. She adds that the Medicaid population is usually stereotyped as high-risk and chronically ill—this can affect the way doctors and providers view treatment for these beneficiaries since the costs of those patients is often higher.

“It’s really a game changer,” said Dr Chang, “A lot of providers think of Medicaid as people who take a lot of time to see, who use a lot of resources.”

A shift in beneficiary demographics could also mean a greater focus on prevention and family care, rather than chronic disease. Sara Rosenbaum, a health law professor at the George Washington University School of Public Health, says the new information could give hesitant states the incentive they need to pursue Medicaid expansion. “It’s about the need for good family care, routine care,” she said. “One would hope that encourages states to open up their programs.”

Around the Web

How Expansion Will Change The Look Of Medicaid [NPR]

Law Will Shift Demographics For Medicaid Toward Healthier Group, Study Finds [Kaiser Health News]