• Menu
  • Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar

Before Header

  • About Us
  • Lexicon
  • Contact Us
  • Our Store
  • ↑
  • ↓
  • ←
  • →

Balloon Juice

Come for the politics, stay for the snark.

Jack be nimble, jack be quick, hurry up and indict this prick.

The republican ‘Pastor’ of the House is an odious authoritarian little creep.

The “burn-it-down” people are good with that until they become part of the kindling.

At some point, the ability to learn is a factor of character, not IQ.

Since we are repeating ourselves, let me just say fuck that.

Speaker Mike Johnson is a vile traitor to the House and the Constitution.

I’m starting to think Jesus may have made a mistake saving people with no questions asked.

Republicans are the party of chaos and catastrophe.

Come on, man.

America is going up in flames. The NYTimes fawns over MAGA celebrities. No longer a real newspaper.

Fight for a just cause, love your fellow man, live a good life.

… pundit janitors mopping up after the gop

One lie, alone, tears the fabric of reality.

Cancel the cowardly Times and Post and set up an equivalent monthly donation to ProPublica.

Our job is not to persuade republicans but to defeat them.

White supremacy is terrorism.

This really is a full service blog.

Their boy Ron is an empty plastic cup that will never know pudding.

Fight them, without becoming them!

Jesus, Mary, & Joseph how is that election even close?

People are weird.

“Jesus paying for the sins of everyone is an insult to those who paid for their own sins.”

The press swings at every pitch, we don’t have to.

“Can i answer the question? No you can not!”

Mobile Menu

  • Seattle Meet-up Post
  • 2025 Activism
  • Targeted Political Fundraising
  • Donate with Venmo, Zelle & PayPal
  • Site Feedback
  • War in Ukraine
  • Submit Photos to On the Road
  • Politics
  • On The Road
  • Open Threads
  • Topics
  • COVID-19
  • Authors
  • About Us
  • Contact Us
  • Lexicon
  • Our Store
  • Politics
  • Open Threads
  • 2025 Activism
  • Garden Chats
  • On The Road
  • Targeted Fundraising!
You are here: Home / Anderson On Health Insurance / Woodworkers and assignment flexibility

Woodworkers and assignment flexibility

by David Anderson|  May 2, 20161:52 pm| 11 Comments

This post is in: Anderson On Health Insurance

FacebookTweetEmail

Charles Gaba notes today that Pennsylvania’s  Medicaid Expansion has seen more people sign up for it than were projected to be eligible for it.  Michigan had the same pattern.

Officials expected that up to 600K would be eligible, and as of last summer 439,000 had already signed up. By December it was up to 500K.

Well, one year after standard expansion went live, the state of Pennsylvania is reporting that:

As of April 2016, the expansion had reached 625,970 newly eligible Pennsylvanians, ages 18 to 64.

Yup, that’s 26,000 more people enrolled than anyone had even thought were eligible for the program.

I think a few things could be going on here. The first is that our system of counting the poor and near poor and the high income variance might not be as good as we thought it was.

Secondly, I think the woodworker situation should be examined. Woodworkers is a wonk term for people who were eligible for Legacy Medicaid but did not sign up for it. However there has been a three year consciousness raising outreach on the importance of getting health insurance as well as increased connectors to assistance combined with fewer administrative barriers to signing up for Medicaid (both Legacy and Expansion flavors of Medicaid).  So a lot of people who were Legacy Medicaid eligible came out of the “woodwork” and signed up for Medicaid during one of the open enrollments.

My question on this is on the sub-population of Medicaid woodworkers who through a variety of circumstances could qualify for both Legacy Medicaid and income based Medicaid expansion.  I know in states with a 1115 waiver such as Arkansas, these individuals are moved to the Legacy Medicaid pool but I am not sure how this works in states with a straight-up expansion.

Legacy Medicaid is split funded.  The Federal government pays through the FMAP between 50% and 74.3% of Legacy Medicaid medical costs.  The state picks up the remainder.  Administrative costs are split a bit differently.  Expansion Medicaid is currently single source funded.  It is, until the end of this year, a 100% Federal program.  Going forward it will eventually be a 90%-10% Federal/State split.

This is important from a state Medicaid administration point of view.  An individual who is categorized as a Medicaid Expansion member is far cheaper (currently free) to the state government than someone who is on the books as a Legacy Medicaid member.  From an individual beneficiary point of view, there is minimal difference besides different codes on their ID card, but this is a big deal at the administrative level.  The states have every incentive to move as many people who could conceivably be qualified as Expansion eligible and Legacy eligible to Expansion.

My question for Pennsylvania, Michigan and other states with high Medicaid expansion enrollment is what percentage of those individuals are unique new individuals to Medicaid who would not have qualified under Legacy rules when they applied?  If that number is low, then the shifting of membership to FMAP optimization categories would be low.  If that number is high, then there is significant optimization happening.

FacebookTweetEmail
Previous Post: « Only The Government Deserves Privacy
Next Post: Hell’s Trapdoor (Open Thread) »

Reader Interactions

11Comments

  1. 1.

    piratedan

    May 2, 2016 at 2:26 pm

    it’s an obvious indication of how Obamacare is failing and is the beginning of the death spiral and how the GOP plan would have prevented this from happening by only allowing those that should have insurance, to have insurance.

  2. 2.

    Villago Delenda Est

    May 2, 2016 at 2:33 pm

    Just goes to show that this is complex, there are many variables, and the more variables, the more difficult it is to come to a concise, omniapplicable conclusion.

  3. 3.

    rikyrah

    May 2, 2016 at 2:41 pm

    I’m glad for my fellow citizens that now have access to healthcare.

    Elections.have.consequences.

  4. 4.

    RAM

    May 2, 2016 at 3:37 pm

    I’m wondering if eligible applicants feel there is somehow less stigma attached to applying for Medicaid now that it’s part of the ACA.

  5. 5.

    Scamp Dog

    May 2, 2016 at 3:51 pm

    @piratedan: Exactly! An impoverished country such as ours can’t possibly afford to take care of everyone. Which doesn’t at all contradict the idea that we’re the richest, bestest country in the world, I’ll have you know!

    /wingnut

  6. 6.

    Gelfling545

    May 2, 2016 at 4:05 pm

    I suspect, too, that now that the expansion is in effect people don’t have to be quite so concerned that they might get an extra shift at work & make $25 too much & get kicked off Medicaid. I know of a few people who didn’t bother because of the on/off cycle which can be really stressful plus you could end up owing the county money. The expansion leaves a bit more leeway.

  7. 7.

    Randy P

    May 2, 2016 at 4:43 pm

    It’s nice to be proud of my state. This is directly due to electing a Democratic governor last year. I don’t know how the wingnuts in the state will manage to either miss that connection or think the expansion is a bad thing, but I’m confident they’ll manage.

    Meanwhile, other Corbett damage is only slowly being repaired because we only got a state budget about a month ago, 9 months late. I wonder what party has control of the legislature that caused that disaster? I feel for the people of Illinois, still going through this completely unnecessary death-by-government-body-that-doesn’t-govern.

  8. 8.

    Alex

    May 2, 2016 at 5:08 pm

    @Gelfling545: Yeah, and not having the asset limit is a huge plus. Or a spend-down. People on the expansion don’t have to worry that their bank balance might edge up over $2000 before they pay their bills, or that saving anything for retirement will lose them their healthcare. And they don’t have to spend a massive amount up front on healthcare every month in order to get insurance. It’s got to cost a lot less to administer when you aren’t monitoring assets and spend-downs all the time.

    Expansion Medicaid is less intrusive because it isn’t aimed at ensuring beneficiaries are and stay destitute. As a result, it’s more user-friendly and cheaper to run. Win-win.

  9. 9.

    Fake Irishman

    May 2, 2016 at 5:12 pm

    I was under the impression that woodworkers would simply be assigned to the state’s legacy Medicaid population (with the relevant match rate). Or was I missing something in your piece?

  10. 10.

    Richard Mayhew

    May 2, 2016 at 6:45 pm

    @Fake Irishman: there is wiggle room in how a state can define category of assistance. An individual who on 12/31/13 is legacy Medicaid eligible but not enrolled could become Legacy and Expansion eligible on 1/1/14. Which bucket does a double qualified individual gets put in? From a state budget perspective the state wants every vaguely defensible case to go into Medicaid Expansion bucket.

  11. 11.

    narya

    May 3, 2016 at 9:31 am

    As a resident of Illinois, I’d say that it’s the governor who’s not governing; the legislature is blocking him, and thank FSM someone is, because his whole agenda consists of (a) taking over the schools, especially in Chicago (presumably to sell it off to a Republican crony) and (b) destroying public unions. The most recent proposal is a graduated income tax (and our income tax rate is laughably low already), and he immediately fulminated about how it wouldn’t raise enough money and it Wasn’t Fair. Asshole.

    W/r/t Medicaid expansion, I think it’s definitely a combo of the increased ability to stay on/eligible (as opposed to running the risk of being kicked off if you earn an extra nickel), and a massive effort to get people enrolled. At least in Illinois, there have been state funds (and we, as a community health center, have also received federal funds) to get people enrolled in insurance. A LOT of effort has been put into helping people understand their options, get enrolled in something they can afford, and then how to use the insurance (e.g., bring your insurance card with you when you come in for care). There are also signs all over the place–billboards, public transportation, etc.–encouraging people to get enrolled in insurance of some kind and providing phone numbers to do it; never saw that before Obamacare.

Comments are closed.

Primary Sidebar

On The Road - beckya57 - Copper Canyon, Mexico, April 2025 6
Image by beckya57 (6/19/25)

Recent Comments

  • dc on AM in NC – NO KINGS – Durham, NC (with the Durham images this time!) (Jun 19, 2025 @ 4:03pm)
  • Leto on Excellent Read:‘The Struggle to Fulfill Juneteenth’s Promise and Reckon with Its History’ (Jun 19, 2025 @ 4:01pm)
  • cmorenc on Excellent Read:‘The Struggle to Fulfill Juneteenth’s Promise and Reckon with Its History’ (Jun 19, 2025 @ 4:00pm)
  • cain on Excellent Read:‘The Struggle to Fulfill Juneteenth’s Promise and Reckon with Its History’ (Jun 19, 2025 @ 4:00pm)
  • cain on Excellent Read:‘The Struggle to Fulfill Juneteenth’s Promise and Reckon with Its History’ (Jun 19, 2025 @ 3:59pm)

Personality Crisis Podcast (Cole, DougJ, mistermix)

Balloon Juice Posts

View by Topic
View by Author
View by Month & Year
View by Past Author

Featuring

Medium Cool
Artists in Our Midst
Authors in Our Midst
No Kings Protests June 14 2025

🎈Keep Balloon Juice Ad Free

Become a Balloon Juice Patreon
Donate with Venmo, Zelle or PayPal

Calling All Jackals

Site Feedback
Nominate a Rotating Tag
Submit Photos to On the Road
Balloon Juice Anniversary (All Links)
Balloon Juice Anniversary (All Posts)
Fix Nyms with Apostrophes

Social Media

Balloon Juice
WaterGirl
TaMara
John Cole
DougJ (aka NYT Pitchbot)
Betty Cracker
Tom Levenson
David Anderson
Major Major Major Major
DougJ NYT Pitchbot
mistermix

Keeping Track

Legal Challenges (Lawfare)
Republicans Fleeing Town Halls (TPM)
21 Letters (to Borrow or Steal)
Search Donations from a Brand

Site Footer

Come for the politics, stay for the snark.

  • Facebook
  • RSS
  • Twitter
  • YouTube
  • Comment Policy
  • Our Authors
  • Blogroll
  • Our Artists
  • Privacy Policy

Copyright © 2025 Dev Balloon Juice · All Rights Reserved · Powered by BizBudding Inc

Share this ArticleLike this article? Email it to a friend!

Email sent!