Archive for the ‘Health Care In The States’ Category

Health Law Push Brings Thousands Into Colo. Medicaid Who Were Already Eligible

The big marketing push to get people enrolled in health coverage between October and March resulted in 3 million people signing up for Medicaid.

Colorado capitol by Jesse Varner via Flickr

Hundreds of thousands of those people were children who were already eligible and could have signed up even before the Affordable Care Act made coverage much more generous.

They came “out of the woodwork” to get enrolled, analysts say, thanks to the Affordable Care Act’s individual mandate and publicity around its new marketplaces.

In Colorado, nearly 23,000 such children are now getting Medicaid. Their numbers grew Colorado’s Medicaid rolls by 3 percent over last year.

Colorado is one the first of the states that are expanding their Medicaid programs to report how many people coming into the health insurance program for low-income residents could have had coverage before the health law was implemented.

State officials in Washington say 91,000 previously eligible but not enrolled residents got on Medicaid between October and March.

State Medicaid Director Sue Birch said Colorado enrolled 22,784 previously eligible kids in Medicaid and the Children’s Health Insurance Plan (CHIP) from Oct. 1 — when the state marketplace opened — until Feb. 28. Overall, including people who were eligible because of the expansion, Colorado’s Medicaid rolls grew by 23 percent during that period.

The health law called for states to expand Medicaid to anyone earning up to 138 percent of the federal poverty level (about $11,670 for an individual and $23,850 for a family of four), but the Supreme Court said that had to be voluntary. About half the states have opted not to expand.

It was widely assumed that there would be a woodwork effect, but estimates of how many previously-eligible people enrolled around the country are just now starting to come in.

The Centers for Medicare & Medicaid Services last week released a preliminary tally of Medicaid enrollment by state from October through Feb. 28.


Wednesday, April 16th, 2014

Primary Care Shortage? Not For The Insured, Study Shows

Researchers posing as nonelderly adult patients made nearly 13,000 calls to primary care practices across Pennsylvania, New Jersey and eight other states between fall 2012 and spring of last year.

What they found may provide some comfort amid growing concerns of doctor shortages, especially as more people gain coverage through the Affordable Care Act, potentially straining the health system.

Dr. Karin Rhodes, from the University of Pennsylvania and a lead author on the study published this week in JAMA Internal Medicine, says when researchers said they had insurance, they were able to make an appointment about 85 percent of the time — on the first try, no less.

“Capacity exists. I think this is a very optimistic message,” Rhodes says, adding that researchers were usually able to get scheduled within a week. The median wait in Massachusetts was about two weeks.

Rhodes acknowledges the study did not examine the quality of care received, the accessibility for returning patients or the role of cost in determining patients’ real access to services. (more…)

Tuesday, April 8th, 2014

Why Some Don’t Pay Their Obamacare Premium: It’s Not What You Think

A new analysis finds that many people who signed up for a Covered California health insurance exchange plan are likely to drop the coverage for a good reason: They found insurance elsewhere.

Researchers at the U.C. Berkeley Labor Center released estimates Wednesday showing that about 20 percent of Covered California enrollees are expected to leave the program because they found a job that offers health insurance. Another 20 percent will see their incomes fall and become eligible for Medi-Cal, the state’s insurance program for people who are low income.

In addition to the 40 percent of enrollees who move to Medi-Cal or job-based insurance, between 2 and 8 percent of those who sign up for Covered California are estimated to become uninsured, the analysis noted.

This process — “churn” to those who study health insurance — is well-known in the Medi-Cal and individual insurance market.


Wednesday, April 2nd, 2014 Woes Frustrate In-Person Helpers Around The Country

Last minute health insurance shoppers nationwide turned up in record numbers online Monday, and they also showed up in person at clinics, county health departments and libraries to sign up for Obamacare on the last official day of open enrollment. Here are dispatches from public radio reporters in Ohio, Pennsylvania and Houston — three of the 36 states that are using — and Minnesota, which has one of the most troubled state-run marketplaces.

OBSTACLES IN CLEVELAND: A steady stream of people filed through the doors of the Neighborhood Family Practice, a  free clinic on Cleveland’s near west side Monday, but Leah Pallant, an outreach and enrollment coordinator at the clinic expected many of them to leave without actually selecting a plan before the midnight deadline.

“The website is already in and out,” Pallant said. “The number of people on the website really made it difficult to keep working, because it basically just shuts you out entirely when they have too many visitors.”

Care coordinators constructed an inspirational billboard for folks signing up at the Neighborhood Family Practice (Photo by Sarah Jane Tribble/WCPN).

Federal officials said more than 1.2 million people from around the country had visited by noon Monday, and the site was handling as many as 125,000 people at a time. The site was down from about 3:20 a.m. until 9 a.m. for maintenance and then again later midday; at other points during the day it shunted people into a “virtual waiting room.”

Coordinators in Ohio and across the country encountered many of the same problems as people trying to sign up at home.

Pallant’s colleague, coordinator Jackie Mostow, was working with Cleveland resident Callie Williams. “We can try,” Mostow told Williams, “but what we might end up doing is trying to create an account and we’ll schedule you an appointment to come back.”

Williams, who hasn’t had insurance since the 1990s, said she is willing to wait a bit longer. “Just schedule me an appointment to come back,” she said.


Tuesday, April 1st, 2014

For California’s Uninsured, A Rush To The Finish

Uninsured Californians flocked to shopping malls, beauty salons, clinics and libraries Monday to meet the deadline for enrolling in health coverage.

The website of the state-run insurance exchange,, was so inundated that officials directed some consumers who began online applications to return later to complete them.

The state was seeing a “huge surge” in last-minute applications, with more than 150,000 people signing up in the last week, Peter Lee, executive director of the exchange said Monday. More applications were started on Sunday than any other day since Oct. 1, when open enrollment began on the nation’s insurance exchanges.

By 5 p.m., the website had seen 420,000 unique visitors, slowing it down. “That volume of response is unprecedented,” Lee said.

Altogether, more than 1.2 million Californians have enrolled in health insurance through Covered California, according to Lee.


Tuesday, April 1st, 2014

Insurance Agents Key To California Success Enrolling Asian-Americans

While Latino enrollment has lagged in California’s insurance marketplace, Asians have signed up in numbers outstripping their representation in the pool of eligible people.  According to new Covered California data, the overwhelming majority of Chinese, Korean and Vietnamese enrollees are buying plans through certified insurance agents, as opposed to community groups or the Covered California website.

A Covered California brochure in Chinese.

There is no charge to consumers who work with agents, whose commissions are paid by insurance companies.

Since January, Asians have been enrolling in strong numbers. People of Asian descent make up about 14 percent of California’s eligible pool, according to estimates compiled by the UCLA Center for Health Policy Research and the UC Berkeley Labor Center. Asians reached that target straight out of the gate, making up 13.5 percent of all enrollees by January. They have surged from there. In the most recent data from Covered California, which comprised enrollment from Oct. 1 to Feb. 28, Asians made up 22.9 percent of all enrollees.

Licensed insurance brokers can sell customers plans on the Covered California marketplace, but they must first be specially certified to do so. Covered California says 40 percent of its total Covered California enrollments are coming via these certified insurance agents. But within certain Asian sub-populations, the percentage is much higher, Covered California says:

  • 57 percent of Chinese enrollments are through certified insurance agents (CIAs)
  • 65 percent of Vietnamese enrollments are through CIAs
  • 70 percent of Korean enrollments are through CIAs

These numbers “suggest that the Asian agents are a driving force in helping Covered CA exceed our enrollment goal in Asian communities,” Wendy McAnelly, a public information officer for Covered California, said in an email.

This information was not a big surprise to Simon Chew. He runs Ehealth-Plans, an insurance business with four offices in San Francisco. All his agents are trilingual — in English, Mandarin and Cantonese. Chew estimates he’s signed up 2,000 people since the Covered California marketplace opened last October, and half of them were uninsured. He sees a difference between how Caucasians shop and how his clients — overwhelmingly Chinese Americans and Chinese immigrants — shop. While what he calls the “mainstream market” is comfortable purchasing insurance online, those of Chinese descent want to do business face-to-face, with someone of a similar background.


Tuesday, March 25th, 2014

Local Control Key To Colorado Exchange’s (Moderate) Success

Colorado capitol by Jesse Varner via Flickr

Being an early adopter can be rewarding. Remember how amazing it was to have the first iPhone? But then, sometimes early adopters pay a price, like that early version of the Apple map tool that led to some wrong turns.

Colorado is one of 14 states going through their own version of this with the health law. The first shot at signing up millions for health insurance wraps up at the end of the month, and the vast majority of states are using the federal marketplace,

Those states which built exchanges of their own took tremendous financial risks setting up the marketplaces, working out everything from insurance plan offerings to advertising strategies.

Some states, like Connecticut and California, are reaping the rewards, leading the country in signing up people for insurance. Others, like Minnesota, Maryland and Oregon, have spent lots of money only to see technology fumble, contractor turnover, and director resignations.

Then there are some states in the middle. The people who built Colorado’s health insurance exchange were sure that they were ahead of the game from day one. Months before the Affordable Care Act even passed, a big bipartisan health reform study group here had already concluded the state should create an exchange.


Tuesday, March 18th, 2014

Sebelius Pushes Lagging Enrollment In Ohio

CLEVELAND –  At a health center here Friday, Health and Human Services secretary Kathleen Sebelius said Ohio is off to a “decent start” on health insurance enrollment.

With two weeks left before open enrollment ends under the Affordable Care Act, 79,000 Ohioans have selected a plan on the federally run insurance exchange.

“We’ve got some distance to go. Clearly there is time. Open enrollment on the private market side does end on the 31st of March, ” Sebelius told supporters and staff members at the clinic.

Nationwide, many Republican-led states that have not fully supported the federal law — including Ohio — have been slow to get eligible people enrolled.  Analysts say there are 812,000 residents of Ohio who qualify for a plan on the federally-run exchange. So far, less than 10 percent of those have signed up.

In contrast, neighboring Michigan, which has partnered with the federal government, has enrolled nearly 145,000 or about 20 percent of those eligible. (more…)

Monday, March 17th, 2014

Missouri Pulls Out Stops, But Lags Better-Funded Illinois Effort

Free food and music are notorious for attracting young people; at least that’s the hope of Missouri insurance enrollment counselors.

Before the March 31 deadline under the Affordable Care Act, groups are beefing up their campaigns to bring last-minute customers to the federal health insurance marketplace—especially young people.

Cover Missouri — a coalition of 400 organizations led by the Missouri Foundation for Health — has 130 enrollment events statewide this month. The St. Louis Effort for Aids, for example, planned the Rock Enroll event last Saturday.

Four bands played while attendees munched on Don Carlos tacos. Upstairs, five certified application counselors helped consumers apply for health insurance online and select a plan.


Tuesday, March 11th, 2014

What’s Next For Pennsylvania’s Medicaid Expansion?

Pennsylvania Gov. Tom Corbett has backed away from a controversial work search requirement in his Medicaid overhaul proposal that’s now under federal review. Even so, experts say it’s unclear whether that move will be enough for the plan to gain final approval.

At stake are billions of dollars in federal funding for Pennsylvania and new health care options for up to half a million residents.

Corbett, a Republican, wants to draw down federal funding slated for states opting to expand Medicaid, as part of the Affordable Care Act, and instead direct those funds toward helping low income residents buy private insurance.

Health officials have granted a few states, including Arkansas and Iowa, permission to do just that. But Corbett’s plan differs in other ways.

It originally mandated that able bodied residents who work fewer than 20 hours a week take part in a job training program in order to access coverage.


Monday, March 10th, 2014

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