The sour economy and new rules from Washington that prevented cuts led to a record 3.7 million new Americans last year signing up for Medicaid, the joint state-federal health insurance program for poor families.
The conclusion came from a 50-state survey released by the Kaiser Commission on Medicaid and the Uninsured. The influx of new patients for the nation's largest health insurer amounted to an 8.8 percent increase, significantly higher than the 6.3 percent spike predicted by state officials.
The federal government helped states absorb the cost of the new enrollees by sending states $87 billion in additional Medicaid funding as part of the stimulus package, with $16 billion more to come as part of an extension that lasts through next July. But one of the conditions of the federal stimulus money — and the health care reform package that followed — was that states could not reduce eligibility for the program.
Vernon K. Smith, a principal with the consulting firm Health Management Associates, which conducted the survey for Kaiser, told The New York Times that, without federal aid, "we would have seen cuts on a scale that we've never seen before."
But that doesn't mean states have avoided cuts. In fact, 48 out of 50 states said they had trimmed spending in the last fiscal year, which ended for most states in June. Those reductions largely came by limiting the benefits that patients could receive and by cutting rates to medical providers.
An accompanying Kaiser report also highlighted the problems that states anticipate in rolling out the federal health care reforms, pointed out The Wall Street Journal . The look at five states showed that states worried they would not have enough staffers to execute all of the law's changes.
"The Medicaid numbers," The Associated Press added, "are the latest piece to emerge in a grim statistical picture of the recession's toll. The ranks of the working-age poor climbed to the highest level since the 1960s last year, according to a recent Census report. Nearly 12 million households received food stamps, a record."