Recession, Jobless Rate Push Up Medicaid Enrollment, Says GSPH's Pa. Medicaid Policy Center

Recent economic hardships have put substantial pressure on Pennsylvania’s health care safety net programs, which have experienced significant increases in enrollment, according to a report issued online by the Pennsylvania Medicaid Policy Center (PMPC) at the University of Pittsburgh Graduate School of Public Health (GSPH).

As of February 2010, 17 percent of Pennsylvania’s population—or more than two million people—were covered by the Medicaid program known as Medical Assistance, which pays for medical and long-term care for low-income state residents; and 196,220 Pennsylvania children were covered by the Children’s Health Insurance Program (CHIP), which currently pays for health coverage of children in families who don’t earn enough to afford private health care but earn too much to qualify for Medical Assistance.

“The two programs provide coverage for almost one-fifth of Pennsylvania’s population,” said PMPC Director Judith R. Lave, who also is a professor in the Department of Health Policy and Management at GSPH. “The Medical Assistance costs alone currently account for 16.2 percent of the state general fund, and, as the recession continues and the unemployment rate remains high, the demand for coverage through both of these programs will likely stay significantly high.”

Between July 2006 to June 2009, Medical Assistance enrollment rose 12.1 percent in adults and 9.2 percent among children, according to the report. In the same time frame, CHIP enrollment rose 34.7 percent.

The Federal Centers for Medicare and Medicaid Services projected in October 2008 that nationwide Medicaid enrollment would increase at an average annual rate of 1.2 percent for the next 10 years, but this prediction did not factor in the impact of the economic recession that began in December 2007, the researchers said.

“Pennsylvania’s rate of enrollment increase for the current state fiscal year is 3.3 percent,” Lave said. “And, as other national analyses have shown, as the unemployment rate ticks up, more people must enroll in these medical assistance programs. Even after a recession ends from a national standpoint, there is a one-to-two-year lag before state fiscal conditions recover.”

Between January 2008 and February 2010, the state’s unemployment rate almost doubled, with a corresponding 13.3 percent increase (nearly 253,000 individuals) in enrollment in Medical Assistance.

Monica R. Costlow, a PMPC senior policy analyst, and Rachel Garfield, an assistant professor in GSPH’s Department of Health Policy and Management, coauthored the report, which is available at www.pamedicaid.pitt.edu.