The Affordable Care Act required all states to expand Medicare or lose funds given to them by the Fed Gov't. 26 Republican governors sued the Obama administration and won: The decision by The Supreme Court said that the government cannot force states to expand and those that don't expand Medicaid will not lose money for their current program. Currently two dozen states have not expanded, and they have seen about a 4% increase in enrollment in Medicaid, while states that did expand saw an 18.5% increase in Medicaid Enrollment since Oct 1, 2013 when the marketplace opened.
While open enrollment for private insurance ended, Medicaid remains open throughout the year. Some are wondering is this the FIRST time some individuals are enrolling in coverage. The administration has been unable to say how many new enrollees obtained private or public coverage for the first time under Obamacare. However, a recent study in the New England Journal of Medicine estimated that 10.3 million uninsured Americans have gained coverage through the marketplaces and Medicaid, resulting in a 5.2 percentage point drop in the U.S. uninsured rate since last September. Read more: New Medicaid enrollments
If this 10.3 million number includes the total of new people enrolled in ALL programs (Medicaid, CHIP and private health plans) and 7.2 million enrolled in Medicaid, one would likely conclude that only 3 million bought policies through the exchange. What we also don't know is how many that purchased private insurance 1) received a tax credit (sometimes referred to as a subsidy) to help pay for the premium and 2) how many people that bought through the marketplace previously had a policy. In addition, how many of the 3 million that bought a plan were coming off the state run CHIP plans (which was the state program in place prior to Obamacare for people deemed "uninsurable"? ) So many unanswered questions....maybe we will know more as time goes on.