The number of Kentucky residents with Medicaid coverage could shoot up by nearly 424,000 patients by 2019, and the federal government will foot most of the cost of their treatment.
The Kaiser Family Foundation on Wednesday released a study projecting nationwide increases in Medicaid enrollment over a five-year period beginning in 2014, when most provisions of the health care reform bill will take effect.
If Kentucky aggressively pursues enrolling new Medi caid patients, the percentage of uninsured low-income adults in the state would drop 77 percent, versus a 69.5 percent drop in the number of uninsured people nationally.
The state also stands to get a slightly larger than average share of its Medicaid expansion paid for by the federal government — 95 percent of the costs of covering newly eligible Kentuckians from 2014 to 2019, versus a national average of 92.5 percent.
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The study estimates that if states actively sought to enroll additional Medicaid patients — the uninsured and those earning up to 133 percent of the federal poverty level — the federal government would pay $531 billion of the additional health care cost, with states picking up $43 billion.
Kentucky would have to pay an extra $180 million over the five-year period to absorb the expenses associated with insuring the nearly 424,000 additional people.
It has been estimated for at least a decade that at least 400,000 Kentuckians are uninsured and patch together their medical care from emergency rooms, health departments and stand-alone urgent-care facilities.
With far greater numbers of patients covered, Kentucky has too few doctors to treat them, according to Ken Haynes, president of Saint Joseph Hospital, Saint Joseph East and Saint Joseph-Jessamine. Haynes said the state still faces a challenge treating them: "We need additional physicians to meet the challenges that health care reform is going to produce."
About 2,200 more physicians are needed in Kentucky to meet the national standard of 267.9 doctors for every 100,000 people. The state has about 213.5 active physicians for every 100,000 people.
For some states, the increase in projected Medicaid patients was even more startling than Kentucky's. In Texas, for example, a projected 2.5 million people could be added to the Medicaid rolls.
"We assume that participation rates will be higher, that there will be an aggressive outreach program," said John Holahan, director of the health policy research center at the Urban Institute.
The Kaiser researchers did not specifically ask states how they will pay the extra costs of Medicaid patients. However, Holahan said that since the federal government will pay much of the cost and states will no longer have to pay for caring for the uninsured, states will benefit by aggressively signing up Medicaid patients.
The study concluded that some states might not make efforts to enroll more citizens in Medicaid: "Some states may not aggressively implement health reform and, therefore, not see significant reductions in the uninsured."