Enrollment Up In State Plans
Washington — Despite the disastrous rollout of the federal government’s health care website, enrollment is surging in many states as tens of thousands of consumers sign up for insurance plans made available by President Obama’s health law.
A number of states that use their own systems, including California, are on track to hit enrollment targets for 2014 because of a sharp increase in November, according to state officials.
“What we are seeing is incredible momentum,” said Peter Lee, director of Covered California, the nation’s largest state insurance marketplace, which accounted for a third of all enrollments nationally in October. California — which enrolled about 31,000 people in health plans last month — nearly doubled that in the first two weeks of this month.
Several other states, including Connecticut and Kentucky, are outpacing their enrollment estimates, even as states that depend on the federal website lag far behind. In Minnesota, enrollment in the second half of October ran at triple the rate of the first half, officials said. Washington state is also on track to easily exceed its October enrollment figure, officials said.
The growing enrollment in those states is a rare bit of good news for backers of the Affordable Care Act and suggests that the serious problems with the law’s rollout may not be fatal, despite critics’ renewed calls for repeal.
But the trend also emphasizes how widely experience with the new law varies by location.
Fourteen states and the District of Columbia, covering about one-third of the nation’s population, are operating their own Obamacare marketplaces and have their own enrollment websites. The others, including most states with Republican-led governments, have declined to do so, making their residents dependent on the malfunctioning federal site.
In addition to better-functioning websites, many states that are running their own marketplaces also have significantly more resources to help consumers sign up for coverage.
Many of the states that have declined to run their own websites have also refused to expand the joint federal-state Medicaid program, as the new law allows.
Overall enrollment totals in states using the federal site were dismal in October, according to figures released last week by the federal Health and Human Services Department.
For example, just 2,991 people successfully enrolled in health plans in Texas in October. That was fewer enrollees than in Kentucky, which has a sixth as many residents.
Altogether, only 106,000 people enrolled in health coverage nationwide last month, a figure far below administration projections.
Nearly half of those who enrolled in October were in California or New York. Both states have continued to show growth in their numbers. In New York, enrollment has continued at roughly October’s rate and stands at 24,509, according to state officials.
Even with the growing consumer interest in health insurance in many states, the new marketplaces created by the health law need millions more enrollees. The Obama administration aims to get 7 million consumers into health insurance plans in 2014 to ensure that the marketplaces have enough people to be sustainable.
With fixes still being made to the federal website, it is unclear whether enrollment will catch up everywhere.
White House officials repeatedly have said they hope to have the HealthCare.gov website working for the “vast majority” of users by the end of this month. But spokesman Jay Carney said Monday that the administration also is working with insurance companies to allow consumers to bypass the troubled site and enroll directly with insurers.
In California, Lee said Monday that the federal troubles have made enrollment more difficult even for states that use their own sites. State officials believe enrollment through Covered California has been depressed by media reports of problems with the federal site, Lee told reporters during a call organized by the consumer group Families USA.
Covered California has had to change its marketing strategy to remind Californians that the state website is different from HealthCare.gov.
But while politicians in Washington, D.C., have been fixated on the website problems, many state officials are feeling considerably more optimistic about the law’s long-term prospects.
“We’re going to ride all this stuff out,” said Kevin Counihan, chief executive of Access Health CT, Connecticut’s marketplace.
Counihan, who worked for the marketplace that Massachusetts created after its trailblazing 2006 reforms, said he had been expecting even lower enrollment. Connecticut saw growing enrollment in November: 3,201 people signed up for health plans in the first two weeks of this month, nearing the 4,371 total for all of October.
Enrollment has been even stronger in many Medicaid programs.
Roughly half the states have agreed to expand their Medicaid programs to most low-income residents in 2014. Under the law, the federal government picks up nearly the entire cost of that expansion for the first several years.
Nationwide, nearly 400,000 new people qualified for Medicaid coverage in October, according to federal data. In Oregon, whose marketplace has been one of the few trouble-plagued state sites, the state reported that it has already signed up 70,000 new people up for Medicaid.
Officials nationwide cautioned that drawing firm conclusions about enrollment patterns is difficult at this early stage.
“It’s hard to know what normal looks like yet,” said Bethany Frey, a spokeswoman for Washington state’s marketplace, known as Washington Healthplanfinder.
Many state officials say they think the biggest enrollment surge will take place after Thanksgiving. Consumers face a Dec. 15 deadline to sign up if coverage is to be effective Jan. 1.
The open enrollment period under the law lasts until March 31, giving consumers an additional three months to select health plans in 2014.
Experts also expect more people to sign up for coverage through 2014 as people lose health plans for various reasons, such as job change or divorce.
“We are in the beginning of the first inning of a nine-inning game,” Lee cautioned.