Blog Center for Advancing Health Services, Policy & Economics Research

Medicaid expansion enrollment hits 100 thousand, delays in processing applications remain

Written by Timothy McBride, PhD, MS, Bernard Becker Professor at the Brown School and co-director of the Center for Health Economics & Policy at the Institute for Public Health

Approximately five-and-half months after the expansion of Medicaid began in Missouri the number of individuals enrolled hit 100,000 in early April, and as of April 15, there are now 146,671 in the adult expansion population.  Hitting this milestone is important, but from the start, the process for enrollment has remained challenged and sluggish.  A new brief from the Center for Health Economics and Policy outlines the status of the expansion in Missouri.

The recent growth in enrollment in the Medicaid expansion population in the last two weeks (64,823 enrolled in the AEG group through the two weeks ending April 15,) represented mostly a set of individuals being transferred from one enrollment category to another, and thus, will not affect the overall enrollment in Medicaid. Reports from the state indicate that the recent growth in enrollment is due to converting some individuals currently categorized as pregnant women, adults on Medicaid for families, children aging into adulthood, and those in the Show Me Healthy Babies program. According to an analysis of the official data released by the State of Missouri (see Figure 1,) Medicaid expansion enrollment has been growing by about 2,000 – 3,000 enrollees per week.

Fig. 1

The number of people enrolled in the expansion represented about 36.5% of the projection for enrollment of 274,312 persons that Governor Mike Parson made in his fiscal year budget for this year.  More than 150,000 people have applied for the expansion, but as of the end of February (according to a report from DSS), a large number of these applications (over 70,000) remained “pending” as the state struggles to process these applications on a timely basis, and the average delay in processing these applications was 119 days, the highest recorded in recent history.  As the Missouri Medicaid Enrollment Dashboard produced by our center shows, approximately half of these pending applications come from individuals who applied for Medicaid expansion through the ACA marketplaces, during an open enrollment period that ended in December, while the other half mostly come in through online applications. As the state continues to process these applications, the expansion enrollment will continue to grow.

The Center for Health Economics and Policy is continuing to monitor the progress of Medicaid expansion in the state of Missouri.  Our center has also produced policy briefs,  which discuss the potential impact that expansion is expected to have on Missouri Medicaid enrollees, and the demographics and health status of newly eligible Medicaid beneficiaries.

The Center for Health Economics and Policy at the Institute for Public Health at Washington University in St. Louis advances evidence-based research to improve health and works with policy makers and public health leaders to drive more equitable health policy.