A year into a new effort to expand health coverage, recession-weary Marylanders are flocking to the state's Medicaid program in numbers far greater than expected, costing the state $50 million more in the process.
As of this week, 44,255 additional state residents had enrolled in Maryland's Medicaid system after income limits were significantly relaxed, outpacing projections that enrollment would increase by 26,605.
Officials say the economic downturn has swelled the ranks of the unemployed, driving more people than expected into the public plan.
Still, health advocates are cheering the figures, saying the state is doing the right thing by expanding publicly funded healthcare to adults who have children.
The expansion has been a "godsend" to uninsured families, said John Folkemer, a deputy secretary at the state Department of Health and Mental Hygiene.
"It didn't surprise me that enrollment numbers are so high or that they exceeded expectations," state Del. Peter Hammen, a Baltimore Democrat who is head of a General Assembly committee that oversees health care. "Our [previous] coverage was just so low."
But increased enrollment has also enlarged the price tag. Analysts originally estimated that the expansion would cost $94.6 million in federal and state money yearly. Now the estimate has risen to $144.6 million, according to Tricia Roddy, director of Medicaid planning for the state health department.
While the federal government picks up half the cost, the higher expenses come as Maryland is battling severe budget shortfalls. State health spending has been propped up this year by a major influx of stimulus dollars.
Proponents had hoped to extend the public plan to adults without children this year, but the initiative was a victim of state budget constraints.
"Medicaid delivers very costly health care," said state Sen. Andy Harris, a medical doctor and Baltimore County Republican, who voted against the expansion. "It doesn't deliver efficiently."
Last July, Maryland expanded its public coverage by increasing Medicaid eligibility to adults with children whose household income was 116 percent of poverty, or $20,500 for two parents with one child.
Previously, the cutoff for parents was 40 percent of the poverty level, so the same family would have had to make less than $7,000 per year to be eligible.
Critics had long complained that Maryland, among the wealthiest states, could afford better health care for needy residents.
