"Whether and to what extent states expand Medicaid eligibility will affect not only access to coverage and costs to the federal government and the states, but also the premiums for private insurance coverage.... Individual market premiums could increase in states that opt out of the Medicaid expansion, due to health status differences of new enrollees.... Exchange premiums also may increase due to spreading fixed reinsurance subsidies over a larger enrollee population.... Basic Health Program decisions by states, pending clarifications from HHS, can affect the risk profile of enrollees in an exchange.... Employers may be at greater risk of penalties in states that don't expand Medicaid eligibility."  MORE >>