Medicaid to rise without expansion

As governors consider whether to expand Medicaid under the Affordable Care Act, a report Monday said that states together face $68 billion in additional Medicaid costs from 2013 to 2022 - even if they all opt out of the expansion.

If all states expand the federal-state health insurance program for the poor to people with incomes up to $26,344 for a family of three, based on this year's poverty level, the combined cost for states would be just $8 billion more than if none do, the analysis by the Kaiser Commission on Medicaid and the Uninsured said.

The reason for the relatively small difference is that other provisions of the health-reform law will also lead to increased Medicaid enrollment, but at a higher cost to states because states will not benefit from the ACA provision that the federal government will pick up most of the expansion tab.

The study compared three scenarios for state Medicaid expenditures from 2013 to 2022: spending without the ACA, spending under the ACA with no states expanding Medicaid, and spending under the ACA with all states expanding Medicaid.

If New Jersey expands Medicaid coverage it will face a 4 percent increase, to $87.3 billion over the 10 years, compared with $83.9 billion without the ACA. If it does not expand Medicaid, expenditures will rise 2.2 percent, to $85.8 billion, the study found.

Pennsylvania's Medicaid spending will climb 3 percent over 10 years, to $136.3 billion from $132.3 billion, if it expands the program. If it opts out, the increase would be less than 1 percent, to $133.4 billion, the report said.