The Health Status of New Medicaid Enrollees Under Health Reform

With estimates reaching near 16 million new Medicaid enrollees resulting from the Affordable Care Act (ACA), questions arise about the health status of these new enrollees. Will they have serious chronic conditions or mental health problems, and thus be relatively expensive to cover? Or will they be, on average, younger and healthier and thus less expensive than those currently enrolled in Medicaid?

Urban Institute researchers John Holahan, Genevieve Kenney and Jennifer Pelletier provide a detailed look at the demographics and health characteristics of the new population now eligible for Medicaid under reform. Although the question of healthier vs. sicker depends largely on the Medicaid participation rates under reform, the authors found that those who enroll under ACA are likely to be healthier than nondisabled adults currently enrolled in Medicaid particularly after the initial start-up period. As to the associated costs, the authors find that new adult enrollees are likely to be more expensive to cover than those who will remain uninsured, but less costly than those now using Medicaid.