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U.S. President Barack Obama delivers remarks alongside Human Services Secretary Kathleen Sebelius (R) and other Americans the White House says will benefit from the opening of health insurance marketplaces under the Affordable Care Act, in the Rose Garden
Medicaid expansion is the unsung hero of the Affordable Care Act, probably the most important component of the law for the actual delivery of health care, rather than the expansion of private insurance coverage. Because it's the Medicaid expansion that is reaching some of the most needy of those left out of the existing system. Medicaid is also the early success story of Obamacare, now that enrollments are being calculated. According to Avalere Health, a market analysis firm, 444,000 people thus far have been enrolled in Medicaid in just 10 of the 25 states that have expanded Medicaid under the law. Data isn't available yet for the other 15, so new Medicaid enrollments nationally are likely to be much, much higher.

The states that have decided to expand have been extremely proactive in getting people on board, including people who were already eligible for Medicaid but had slipped through the cracks. Funding from Obamacare has allowed states to increase their outreach and education efforts. For example, Colorado:

In Colorado, Medicaid applications in October were six to nine times what they were the month before, said Sue Birch, who heads the state's Department of Health Care Policy and Financing.

A years-long effort to reach eligible residents apparently succeeded in generating the increased demand. The state has installed self-service kiosks in community clinics, hospitals and libraries to sign people up. And a year ago, nurses statewide agreed to help by promoting Medicaid to low-income uninsured patients. [...]

Some states have used food stamp rolls to find people who might also be eligible for expanded Medicaid. Income verification forms used for food stamps require frequent recertification, so that means the program's beneficiaries are Medicaid-ready.

States can do this now because they can afford to increase Medicaid rolls; Obamacare provides the funding they need to cover their whole low-income populations. This is actually very good news for these states, and for the health care system as a whole. Because while Medicaid is a favorite target for Republicans to trash, it's an extremely efficient and effective program. Consider a recent study from the Journal of General Internal Medicine that found Medicaid is better at delivering access and affordable coverage than either private coverage or Medicare. From an efficiency standpoint, Medicaid is a winner.

Should the other 25 states decide to expand—and they can at any time—there could be efficient and effective health care for millions more, as many as 13 million by 2023, the CBO estimates.

Originally posted to Joan McCarter on Tue Nov 12, 2013 at 10:39 AM PST.

Also republished by Daily Kos.

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