A new study from data analysis vendor Truven Health Analytics predicts a modest increase in Medicaid enrollment in the early years of health care reform as tens of millions of consumers enroll in health insurance exchanges to compare and select a benefit plan.

Based on an assumption of partial state acceptance to expand Medicaid, as the Supreme Court ruled the federal government could not mandate state expansion, the vendor estimates Medicaid enrollment nationwide will increase from 47 million in 2013 to 53 million in 2016. The number of patients enrolled in a health insurance exchange will reach 21 million in 2016.

Using data from its databases containing Medicare, Medicaid and private insurance enrollment rates, Truven Health estimates the number of insured will fall from 49 million in 2012 to 27 million in 2016. Assuming their states expand Medicaid, the Los Angeles and New York City regions will see the largest absolute increases in Medicaid enrollment, while Austin, San Antonio and Houston will have the largest percentage growth.

The study, “Coverage Expansion Under the ACA: Challenges for Government, Health Plans and Providers,” is available here.

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