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Watch This Space: Medicaid Expansion Discussions Ongoing

By Rebecca Adams, CQ HealthBeat Associate Editor

November 22, 2013 -- Most states that so far have not expanded Medicaid are "looking for a way to get to yes," the leader of the National Association of Medicaid Directors (NAMD) said at a recent briefing held by the Alliance of Health Reform and cosponsored by The Commonwealth Fund.

NAMD Executive Director Matt Salo said that the "vast majority" of states in the "no" category would be interested in taking advantage of federal funding to expand Medicaid if they could get the Obama administration to allow them to tweak the program.

Some are interested in allowing newly eligible Medicaid enrollees to get coverage through the new marketplaces, as Arkansas is doing.

A few of the states to watch next year include New Hampshire, where expansion did not make it through the process in a special session that ended last week despite Democratic Gov. Maggie Hassan's support; Florida, where hospitals are lobbying hard for expansion in the state legislative session that starts in the spring; and Virginia, where newly elected Democratic Gov.-elect Terry McAuliffe supports broadening the program.

The wide-ranging Alliance briefing was centered on the new marketplaces, but people who apply are supposed to be evaluated for Medicaid coverage as well.

At the same briefing, D.C. Health Benefit Exchange Authority Executive Director Mila Kofman released a limited amount of basic demographic data. The data were for only the first 120 enrollments, but gave an indication of interest among D.C. residents. The highest number of enrollments were among those between the ages of 31 to 40, Kofman said, followed by those in the 20- to 30-year-old age bracket and then the 51- to 60-year-old category.

Most picked the platinum level of coverage, which surprised Kofman. She also said the exchange got several enrollments from people who were 65 years old or older. She was not sure whether they were ineligible for Medicare or trying to drop Medicare to enroll in a marketplace plan.

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