Oregon is one of twenty-five states and Washington D.C. that are expanding Medicaid in 2014 under the Affordable Care Act, to include those who are at or below 138% of the federal poverty level ($15,856 for a household of one and $32,499 for a household of four). This is good news for 45% of Oregon workers, who earn less than $31,000 a year.

States Prepare for Increasing Medicaid Enrollment

All states expanding Medicaid have invested in new eligibility systems and information technology to facilitate new Medicaid enrollment in 2014. Twelve of the states are converting previous state-based insurance programs into Medicaid coverage. None of the expanding states expect the majority of Medicaid enrollment in their states to come from Healthcare.gov, so the challenges experienced by the federal government’s website will probably have little to no impact for 2014 on Medicaid enrollment.

Federal Match Rate Creates Cost Savings for States

The 100% federal match rate for Medicaid enrollees newly eligible under the ACA makes it nearly impossible for state costs to increase in the short-term. Oregon Medicaid officials predict that Medicaid expansion will result in savings for the state budget over the next decade. However, there is some uncertainty about the future of the federal match rate.

Doctors Express Dissatisfaction with Medicaid

If you ask Oregon doctors about Medicaid up to 2014, you get a different response. They report reimbursement rates 25% less than Medicare (Oregon has some of the lowest Medicare rates in the US). Paperwork involved with forms, reports, and claims processing results in five times as much work for less than a third of what a commercial patient pays. As a result, many doctors have had to limit the number of Medicaid patients they will treat, with wait lists of 4-5 months.

State cost savings from federal reimbursement match needs to be passed on to doctors to make delivering care economically feasible. Doctors also need to be freed from the burden of endless paperwork to be able to efficiently and cost effectively deliver quality care. The system must work for all those involved to accommodate the increasing number of predicted Medicaid enrollees.