More Medicaid Enrollees: It's Not Just About The Money

May 9, 2014

As you may know, far more Rhode Islanders signed up for Medicaid than expected recently. And the state is on the hook for millions more dollars than anticipated to care for them. The federal government is picking up the tab for now for people who became newly eligible for the program under the Obamacare Medicaid expansion, which Rhode Island opted to accept (unlike some other states). That allowed childless adults, men and women, earning less than a certain amount a year, to get health insurance, some perhaps for the first time. But lots of folks who were already eligible for Medicaid signed up, too. That's what the state wasn't expecting, and that's what they're trying to figure out how to pay for on Capitol Hill now.

Altogether, more than 70,000 Rhode Islanders signed up for Medicaid over the past year, about 20,000 more than anticipated.

So here's what I've been pondering: how many of those have never had insurance before? How many have been putting off seeing the doctor for anything but an emergency? How many will now be in search of a primary care doctor? Do we have enough of those? And how many new insurance cardholders understand how to find a good primary care doctor and how to work with him or her to manage their health?

I imagine the health plans that manage Medicaid members, like Neighborhood Health Plan of Rhode Island, may have had to beef up staff, or fire up more printers to churn out all the new member materials they've had to mail out. Waiting to hear back from them on that.

Even if you've been lucky enough to have health insurance for most of your life, it can be tough to navigate. It's not easy to find a primary care doctor. And even when you do, you're still in the driver's seat when it comes to managing your health. When to schedule appointments? What screenings, what specialists do I need? Insurers offers lots of educational materials for members, but do these thousands of Rhode Islanders- possibly new to the world of health care covered by insurance- need a “how to use health care 101”? What’s been your experience dealing with an insurance company and what advice would you give to someone navigating the system for maybe the first time?