Costs Drive MEDICAID'S REALITY

In the next 12 months, Medicaid enrollment and costs will be on the verge of exploding. From 2005 to 2011, enrollment grew by 10 million, but an additional 16 million to 22 million are expected to sign up as health reform goes into effect. The program today covers 60 million Americans, and federal and state authorities share the burden of providing more than $400 billion in annual funding. As the provisions of the Patient Protection and Affordable Care Act (PPACA) edge closer to reality, the Medicaid program faces unprecedented change, with day-to-day challenges as well as longer term issues such as access, outcomes and payment mechanisms. Even without PPACA expansion of Medicaid populations, the increase in numbers of low-income Americans has caused an uptick in enrollment. A lack of trust in the federal government among states has fueled some of the resistance to opening up Medicaid rolls, says Matt Salo, executive director at the National Association of Medicaid Directors.