States that have chosen to expand Medicaid programs as permittedby the Patient Protection and Affordable Care Act will representthe greatest opportunities for increased health insurance salesduring the next two years, according to an Avalere Healthstudy.

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Avalere used its model for Medicaid managed care enrollment tocreate projections on a state-by-state basis for new coveredindividuals enrolling in Medicaid and Children’s Health InsuranceProgram. For 2015, Avalere’s projections suggest that 79 percent ofthose eligible for coverage in expanded Medicaid states will be enrolled,versus 74 percent in the United States overall. The gap betweenexpanded states and those that chose not to expand is higher,Avalere said.

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Read: Double-digitgrowth forecast for Medicaid enrollment

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“The vast majority of people who have insurance as a result of the Affordable CareAct are enrolled in private plans,” said DanMendelson, CEO of Avalere Health. “This is a major businessopportunity for plans, and often also helps to promote continuityof care as low income people migrate between Medicaid andsubsidized exchange coverage.”

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Avalere projects that 13.5 million new individuals will enrollin Medicaid and CHIP managed care plans from 2013 to 2016, and saidthat managed care enrollment will increase from 67 percent of totalMedicaid and CHIP enrollees in 2013 to 76 percent in 2016.

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Avalere noted that the Centers for Medicare & MedicaidServices reported an additional 8.7 million people have enrolled inMedicaid as a result of the PPACA.

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“The growth is attributable to states’ decisions to expand theprogram, as well as the indirect effects of people learning aboutand enrolling in programs for which they were previously eligible(sometimes called ‘the woodwork effect’),” Avalere said in arelease.

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“Medicaid managed care offers states the opportunity to delivercoordinated care to Medicaid beneficiaries at a defined cost,” saidCaroline Pearson, vice president at Avalere Health. “As a result,the projected growth in Medicaid managed care enrollment is drivenby not only expansions under the ACA, but also state decisions toexpand managed care programs to all or most of their existingbeneficiaries.”

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Avalere said enrollment in Medicaid managed care “isparticularly high in states that decided to expand Medicaid — bothbecause these states relied on managed care more heavily before ACAexpansion and because newly eligible beneficiaries are largelyenrolling in managed care plans. … Of the 28 states and theDistrict of Columbia committed to expansion, 16 states and D.C.plan to enroll over 90 percent.

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Also read: Whatnew Medicaid enrollees think about their coverage

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Dan Cook

Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.