I got an e-mail from Avalere Health:
According to a new Avalere Health analysis, 17 of the 26 states that did not expand Medicaid in the first three months of 2014 still reported growth in Medicaid enrollment, ranging from 0.1 percent in Texas to 10.1 percent in Montana. Since these states had decided not to expand Medicaid eligibility levels under the Affordable Care Act (ACA), these numbers show the impact of the “woodwork effect,” which is when individuals who were previously eligible, but not enrolled in Medicaid, newly sign up as a result of increased outreach and awareness. These enrollees may place a strain on state budgets, since states are required to contribute to the cost of their coverage based on traditional Medicaid matching rates. . . .
These states would have gotten 100% federal reimbursement for newly eligible Medicaid beneficiaries, had they chosen to accept the expansion. But they only get 50-70% reimbursement for these folks, who were already eligible. So their hospitals and docs won't get all that federal money, but they'll still have to cover more Medicaid beneficiaries. Lots of people left out in the cold, of course, but this is a good side effect.