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HealthCare Checkup

The Seattle Times health-care team tracks the local impact of the Affordable Care Act.

January 7, 2014 at 9:36 PM

Medicaid enrollment meeting goals, private insurance falling short

Home page for Washington Healthplanfinder.

Home page for Washington Healthplanfinder.

In the push to make health-care coverage more widespread, Washington is meeting its goals for boosting the number of people covered by Medicaid, while the state is lagging in its enrollment in the new health insurance marketplace.

By Jan. 2, more than 121,258 adults newly eligible for Medicaid had enrolled in the program, which locally goes by the name Washington Apple Health. That number was just a few hundred short of the program’s goal, and an additional 6,000 people have enrolled since the beginning of the month, a state spokesman said Tuesday night.

More than 71,205 Washington residents and their families have signed up for and made their first payment for private health insurance available through the insurance exchange, found at Washington Healthplanfinder. The state originally set a goal of 130,000 enrollees by Jan. 1.

“It was hard to tell — this being a new program — what the uptake would be,” said Bethany Frey, spokeswoman for the health insurance exchange. “We may hit that target by the end of March.”

An additional 72,178 people have begun but not completed the insurance enrollment process. It’s not clear how many of these will ultimately finish their applications.

“We are off to a really good start,” Frey said.

Exchanges across the nation launched online on Oct. 1 of last year. Washington’s marketplace hit some technical bumps including miscalculations in subsidy amounts, puzzling error messages and difficulties completing applications. But the state has made multiple fixes to the site and enrollment numbers in Medicaid and the insurance program have continued to steadily climb.

Because of the glitches, people who began the insurance enrollment process by Dec. 23 but were unable to complete it by that deadline will still be able to get insurance coverage retroactive to Jan. 1, provided that they make their first insurance premium payment by Jan. 15. The state has a fact sheet available for people in this situation.

Most Americans must have insurance coverage through private insurance, Medicaid, Medicare, their employer or other federal programs by March 31, 2014 or face a penalty.

The state set a goal of 280,000 enrollees in the Healthplanfinder exchange by January of next year.

Washington was one of the states that opted to expand its Medicaid program, which now offers benefits to people earning 138 percent of the federal poverty level, or nearly $16,000 for an individual and almost $27,000 for a three-person family.

In addition to the 121,258 in new adult enrollments, more than 156,000 people have renewed their Medicaid enrollment.

“This is early evidence of the previously unmet demand for affordable coverage in Washington, and continued success on this front will be essential for meeting the needs of nearly 1 million uninsured residents in our state,” Dorothy Teeter, director of the Washington Health Care Authority, which manages the state’s Medicaid program, said in an emailed release.

The agency expects an additional 58,000 newly eligible adults will enroll in Medicaid/Apple Health through the rest of the year.

Both Medicaid clients and people shopping for subsidized individual insurance enroll for the programs through the Healthplanfinder website. Insurance for individuals is also available outside of the exchange, but those plans are not eligible for tax breaks.

As the website has improved, so has the toll free call center meant to assist people struggling with their enrollment. The center was overwhelmed by calls in previous months, resulting in long hold times and some calls simply being dropped. The facility has increased its staff and the state reported Tuesday that the average wait time is now five minutes

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