Exploring the Medicaid expansion program
District 31 Update
By Rep. Karen Rohr
There were several events to attend in June. On Saturday, June 7, Senator Schaible, Representative Schmidt and I participated in the Elgin Parade. As always, it was a pleasure visiting with all of you during and after the event. On Sunday, I had the honor of attending the Mandan Airport Runway Dedication along with Congressman Kevin Cramer, Senator Heidi Heitkamp and Mandan Mayor Arlyn Van Beek. The dedication ceremony commemorated the completion of the reconstruction of 330,000 square feet of runway. Later that afternoon, I went to attend the Buggies and Blues Car Event held in Downtown Mandan. There I had the opportunity to visit with old friends, meet people from as far away as Alaska, and view several blocks of old and new muscle cars. It was a great showing.
In this article, I want to provide an update on the enrollment numbers for the federally-facilitated Marketplace and the N.D. Medicaid Expansion Program as reported at the May Health Care Reform Review Committee meeting.
Federally-Facilitated Marketplace: As you recall from a previous article, the three companies selling on the Marketplace are N.D. Blue Cross and Blue Shield, Medica and Sanford Health. The enrollment numbers provided by these companies are for effectuated polices. This means that people have not only said they want the policy, but they have also paid premiums towards the coverage. As of May 1, N.D. BCBS reported 3,769 enrollees, Medica 1,072, and Sanford 255. The number of covered lives under the effectuated contracts through the Marketplace in N,D, totals 8,374. In contrast, the federal enrollment number reported for N.D. is 10,597.
It is important to note that the federal enrollment number represents individuals who have selected a Marketplace Plan with or without the first premium payment having been received by the Marketplace or the issuer. In addition, the federal number includes special enrollment from individuals that had started but not completed their enrollments by March, 13.
Medicaid Expansion Program: The Affordable Care Act created a new Medicaid group called Medicaid Expansion. Under the previous Medicaid program, only children, pregnant women and families (parents/caretaker/relatives of dependent children) were eligible for Medicaid. Legislation passed in April 2013 expanded Medicaid coverage in N.D. The N.D. Department of Human Services contracted with Sanford Health Plan to provide benefits to Medicaid Expansion recipients beginning January 1.
Individuals who enroll in the Medicaid Expansion program must meet the following criteria: must be between the ages of 19-64, have incomes below 138% Federal Poverty Level (for a single person that is an annual income of $15,856), must be a legal citizen, not incarcerated, and not entitled to Medicare.
Medicaid Expansion enrollment numbers reported at the meeting for N.D. totaled 7,883; however, an update as of June 1, reported 8,961 individuals. Further breakdown of the enrollment numbers demonstrated that approximately 43% were ages 19-35, 16% ages 36-44 and 40% were ages 45-64. 47% were male and 53% were female. Finally, 35% of the recipients were urban (covering only Burleigh and Cass Counties) and 65% were rural. For additional information regarding Medicaid Expansion go to www.nd.gov/dhs/medicaidexpansion/index.html.
In conclusion, the next Health Care Reform Review Committee meeting is scheduled for July. At this meeting, the plan is to review potential bills for the 2015 legislative session.
As always, feel free to contact me at email@example.com and have a great week.