Wash. Medicaid enrollment surpasses reform goals

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SEATTLE (AP) - At least one part of health care reform has exceeded expectations in Washington state: Medicaid sign-ups since the state expanded eligibility for the safety-net program for low-income people.

Washington health officials say 202,000 adults who became eligible for Medicaid because of the Affordable Care Act have signed up as of March 1. That number is well above the state’s goal of enrolling 136,220 people by April 1.

Twenty-five states and the District of Columbia have expanded eligibility to Medicaid to people who earn less than 133 percent of the federal poverty line or about $15,000 for an individual of about $28,000 for a family of three. Four other states are considering it.

Federal and state reports on Medicaid expansion make it difficult to judge whether others are doing as well as Washington at signing people up for the free insurance since the expansion.

The Obama administration says more than 8.9 million people have been “determined eligible” for Medicaid from Oct. 1 through the end of January. But a study by Avalere Health estimates the actual number of new sign-ups could be much lower, between 2.4 million and 3.5 million.

The administration’s number includes many people renewing existing coverage. Avalere’s estimate includes those eligible for the expanded program, as well as some who were already eligible but had not previously enrolled.

Washington reports on both Medicaid groups, but it offers separate numbers. In addition to the 202,000 newly eligible adults, about 102,000 Washington residents who were previously eligible for Medicaid but had never signed up have now enrolled. Another 312,000 people have renewed existing coverage.

They come from across the state, and most counties have beat their enrollment targets, said Nathan Johnson, director of policy, planning and performance for the Washington Health Care Authority.

Johnson credited public and private organizations for the early success, including the Washington health exchange’s marketing efforts and nonprofit community organizations reaching out to their members to encourage people to sign up for free or low-cost health insurance.

Dr. J. Mario Molina, president and CEO of Molina Healthcare, said the Washington health exchange didn’t just sell insurance to people, it signed up the poor for free coverage. Molina Healthcare is the state’s largest Medicaid managed-care plan provider.

Thousands have checked out the exchange to see how much insurance would cost them and found they were eligible for Medicaid. Historically, 20 percent of people who are eligible for Medicaid don’t sign up, but the exchanges may change that number, Molina said.

“The exchanges have been very good for Medicaid patients,” he said.

Johnson said the state’s goal was to enroll 250,000 new people in Medicaid by 2017. That’s about half the number the state estimates to be newly eligible. Johnson expects that goal will be reached and possibly surpassed much sooner.

“What we can’t forecast for you is whether the pace of enrollment will keep up,” Johnson said, adding that daily counts do not show any signs of slacking off. “We might see this level off tomorrow, or it might not level off for some time.”

He acknowledged that the estimates were educated guesses because the state has never done an expansion of this sort for adults in the past and wasn’t sure how much pent-up demand the expansion would meet.

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