The states that have decided to expand have been extremely proactive in getting people on board, including people who were already eligible for Medicaid but had slipped through the cracks. Funding from Obamacare has allowed states to increase their outreach and education efforts. For example, Colorado:
In Colorado, Medicaid applications in October were six to nine times what they were the month before, said Sue Birch, who heads the state's Department of Health Care Policy and Financing.States can do this now because they can afford to increase Medicaid rolls; Obamacare provides the funding they need to cover their whole low-income populations. This is actually very good news for these states, and for the health care system as a whole. Because while Medicaid is a favorite target for Republicans to trash, it's an extremely efficient and effective program. Consider a recent study from the Journal of General Internal Medicine that found Medicaid is better at delivering access and affordable coverage than either private coverage or Medicare. From an efficiency standpoint, Medicaid is a winner.
A years-long effort to reach eligible residents apparently succeeded in generating the increased demand. The state has installed self-service kiosks in community clinics, hospitals and libraries to sign people up. And a year ago, nurses statewide agreed to help by promoting Medicaid to low-income uninsured patients. [...]
Some states have used food stamp rolls to find people who might also be eligible for expanded Medicaid. Income verification forms used for food stamps require frequent recertification, so that means the program's beneficiaries are Medicaid-ready.
Should the other 25 states decide to expand—and they can at any time—there could be efficient and effective health care for millions more, as many as 13 million by 2023, the CBO estimates.