The Editorial Board | December 15, 2013
After a botched start, the number of people signing up for health insurance plans under the Affordable Care Act has accelerated greatly, with the most substantial gains occurring in Medicaid programs for the poor.
Federal health officials announced on Wednesday that some 1.2 million people selected plans on federal or state exchanges during the months of October and November. That included 803,000 people who applied to the exchanges and were found eligible for Medicaid or a related Children’s Health Insurance Program that provide public insurance for the poor — in addition to nearly 365,000 people who chose private plans.
Outside the exchanges, there has also been an increase in applications sent directly to state agencies that run Medicaid and CHIP. Applications were up 15.5 percent in October in states that are expanding their Medicaid programs and up 4.1 percent in states that are not.
Under the Affordable Care Act, states are authorized to expand Medicaid, with the help of extremely generous federal subsidies, to cover residents with incomes at or below 133 percent of the federal poverty level, or about $15,280 for an individual and $31,320 for a family of four. Twenty-five states and the District of Columbia are expanding their programs. The others, led mostly by Republican governors, have taken no action or adamantly refused to expand, either because they are politically opposed to the health care reform law or fear their small share of the costs would strain state budgets.
Medicaid enrollments have not been completely smooth. There are still glitches in the computer systems that are supposed to transfer data about applicants and their eligibility for Medicaid to the states, but federal officials are working on ways to ease that problem.
For people with incomes too high for Medicaid, enrollment appears to be getting much easier as repairs are made to the federal website. The number of people who chose private health plans through the federally run exchanges was four times as high in November as in October, and the number who chose private plans through state-run exchanges also increased substantially, not quite doubling from October to November.
At the current rate, more than a million people may select private health plans by Jan. 1, the earliest date the new policies can take effect. That’s fewer than the administration had originally hoped, but surprisingly robust given the start-up troubles.
There are still glitches in the systems that are supposed to transfer financial data about consumers and their eligibility for federal subsidies to insurance companies. Administration officials hope to fix that problem in time to accommodate an upsurge in applications as the enrollment period runs on to the end of March.
Source: NY Times