One of the key components of ObamaCare is Medicaid expansion, which allows states to add able-bodied, working age adults who earn less than 138% of federal poverty level to the Medicaid rolls – with the financial support of taxpayers. And in states where legislators are considering expansion state taxpayers are often told not to worry about the costs and projections under expansion because the feds have it all taken care of.   But what if cost projections and enrollment exceeds estimates?  Taxpayers beware.

A new report out this week from The Foundation for Government Accountability details just how inaccurate original Medicaid enrollment projections were and how expensive expansion may become.

Each state estimated the number of its citizens who would sign up for Medicaid expansion before they began enrollment.  Many legislators sold the program as cheaper than you would expect because of the low projected enrollment numbers.  It turns out many states were wrong. In fact, 16 of the 17 states that had data available are over their maximum lifetime projected enrollment, and all 17 states with data are over their one year projected enrollment.

Screen Shot 2015-04-23 at 2.30.36 PM

Here are some of the biggest enrollment explosions:

Before Kentucky decided to expand Medicaid under ObamaCare, they estimated 154,000 people would sign up in year one. The actual number? A whopping 375,000! That’s more than double their initial estimate and stands to cost taxpayers $1.8 billion extra in fiscal years 2014 and 2015.

Several states out west are among the worst offenders. Washington state enrolled 108 percent more than their 2014 projections. In fact, they blew through their initial estimate of of 245,000 in just the first two months and are already 104 percent over what they projected their lifetime enrollment would be.

But it’s even worse in the Silver State.

Nevada missed the mark with an enrollment that is 111 percent over original projections. By January 2015 their program had already exploded to over 166,000 enrollees. The state had originally projected a maximum lifetime enrollment of only 78,000. Not surprisingly, this massive spike in enrollment has shocked the state’s health care system and lead to access issues for patients.

California has the honor of being the state with the largest increase over their maximum projections.

California’s enrollment more than doubled their projections at 120 percent! The Golden State had projected a maximum of 910,000 individuals would ever sign up for ObamaCare’s Medicaid expansion, but they blew by that number hitting 2 million people in September 2014.

Expect those numbers to be even higher when figures are updated for 2015.

FGA CEO Tarren Bragdon addressed the enrollment explosion:

“The fact that every state with available data has outstripped their projections should serve as a strong warning to any state that is considering ObamaCare’s Medicaid expansion. There are no effective estimates of costs and these programs are unpredictable, meaning and lawmaker who supports expansion is willing to put his constituents’ paychecks on the line for a political gamble.”

As the report notes, with this enrollment explosion, “states that adopted the expansion will soon need to find additional funds to pay for the inevitable cost overruns.”

Unfortunately, because of “ObamaCare’s perverse funding scheme,” it “encourages state budgeters to steal resources from seniors, children, pregnant women, and individuals with disabilities in order to free up funding for Medicaid expansion.”

After all, states typically receive $1.32 in federal funding for every state dollar spent on traditional Medicaid, compared to the $19 they are set to receive for every dollar spent on ObamaCare expansion in 2017. Put simply, ObamaCare’s immoral funding formula puts truly vulnerable Medicaid patients in the crosshairs in order to fund a new entitlement for able-bodied adults.

With 2017 budgeting for many states just around the corner,  states that opted to expand Medicaid under ObamaCare are about to be hit with the harsh reality that those explosive enrollment numbers come with a hefty price tag.

Follow Kristina and The FGA on Twitter.


  1. […] the Foundation For Government Accountability […]

  2. […] There’s a report that was released yesterday from the Foundation for Government Accountability that reveals that Medicaid expansion would likely be more of a financial loser for Louisiana than projected. The report found that in the states that expanded Medicaid, they underestimated the number of people who would sign up. […]

Leave a Comment