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6 million Americans qualify for Medicaid but don't sign up

Those who avoid coverage represent challenge to ACA enrollment goals

As many as six million Americans are eligible to get nearly free health coverage through Medicaid but don't sign up, according to the Wall Street Journal

The Centers for Medicare & Medicaid Services has put a great deal of effort into reaching the remaining uninsured, including children who are eligible for Medicaid through the Children's Health Insurance Program. The latest government figures show that during the third open enrollment period for Affordable Care Act coverage, which ended Sunday, 11.6 million people have signed up for or renewed a health plan through Jan. 23.

There are about three million people who now can't get government-funded insurance because their states haven't extended Medicaid eligibility, the WSJ notes. Yet that's still far fewer than the number of those who are eligible and choose not to sign up.

Among the biggest hurdles in getting people to sign up for Medicaid is the lack of knowledge surrounding their motivation for staying out of the system, according to the WSJ article. One possible reason, according to a pollster who has studied people's experiences with Medicaid, is that some may believe their situations are likely to improve and therefore aren't motivated to take action. As a solution, some states have experimented with making individuals eligible for long stretches of time, rather than continuously investing in reassessing their status. 

Government forecasters such as the Congressional Budget Office don't see the number of people who are unenrolled and Medicaid eligible changing much in the future, the article says. Still, expanding Medicaid under the Affordable Care Act helped states streamline both the enrollment and renewal processes and increase administrative effectiveness, FierceHealthPayer has reported.

There were 71 million people signed up for Medicaid as of September 2015, the WSJ article says. Since the ACA took effect in the fall 2013, Medicaid has gained 13 million enrollees.

To learn more:
- here is the Wall Street Journal article
- here's the latest ACA enrollment figures

Related Stories:
CMS launches effort to get children covered through Medicaid, CHIP
Affordable Care Act improves Medicaid efficiency, enrollment
Report: ACA has made Medicaid coordination, re-enrollment much smoother