Even after battling a multitude of challenges, Obamacare managed to score 8 million enrollments. Despite the troubled start, the Obama administration rallied behind the cause and put in efforts to surmount challenges to deliver a viable health exchange enrollment that kept the Affordable Care Act alive. Excluding people who get health insurance through their workplace or through Medicaid or Medicare programs, Obamacare enrolled 28 percent of the people eligible for buying health insurance off the federal marketplace. Out of all the states, let’s take a look at the states that capitalized the most on Obamacare.
Starting with the highest performers in the state segment, Vermont led the charge with 85.2 percent of the eligible market enrolling through the state exchange. A major reason for the success of Affordable Care Act in Vermont was the mandate issued by the state that prohibits enrollees from buying health insurance through any other medium. The District of Columbia also owed its high enrollment rate to this mandate. California stood second in line with 42.7 percent of the eligible population buying health insurance off the exchange. California was responsible for adding 1.3 million enrollments to the 8 million total enrollments. Rhode Island was a near third with 40.6 percent people going for health insurance.
The poorest performing states owed their abysmal performance to exchange issues and lack of initiation toward the ACA. Iowa and South Dakota had only 11.1 percent enrollment, while Massachusetts ranked third with 12.2 percent enrollment. Iowa’s and South Dakota’s poor performance was largely contributed to the absence of Wellmark Blue Cross Blue Shield in the market. Wellmark had the most consumers on board before Obamacare was rolled out, and the outreach capability of this health insurance plan was missing from the state’s strategy to enroll people.
A noteworthy point was that states that had a fully functional state insurance exchange showed the best numbers. On the other hand, states with poorly performing health insurance site, coupled with other challenges, saw a poor enrollment status. For instance, Minnesota, Maryland, and Hawaii suffered huge technical challenges that ultimately marred enrollment through their exchanges. Iowa suffered from a tumbling state-federal partnership exchange, along with the no participation of Wellmark in the market. Similarly, the problems wreaked havoc on states, which were connecting with the federal marketplace for their insurance needs. Nearly 85 percent of the 8 million who purchased health insurance off exchanges availed health insurance subsidies, and most who could not buy health insurance off these exchanges chose to not participate otherwise, leaving the uninsured rate high. On the other hand, people who were not eligible for subsidies chose to avoid the exchanges altogether due to the technical challenges plaguing the insurance exchange.
With the second open enrollment period closing in, the administration plans to learn from the mistakes and present a fully functional federal marketplace.. With a fully functional federal marketplace, the administration can hope to enroll a few million more uninsured under Obamacare. However, the enrollments will become difficult for a variety of reasons.
First, the health exchanges have already captured the people who were desperate to get health insurance. Typically these were people with preexisting medical conditions or ones in need of federal subsidies to cover their healthcare costs. With a major chunk of most eligible uninsured out of the way, this enrollment period will be tougher for the administration. Furthermore several states, such as Oregon, have defaulted to the federal exchange while players like Massachusetts have brought in new vendors [Full Disclosure: hCentive was brought on board to fix the Massachusetts exchange] to improve their health insurance exchange and deliver better experience to users. With more people to cater to, including the enrollees from the last enrollment period, the authorities are stretched thin for resources that can assist people in enrollment. The next period is going to be tougher, but a fully functional federal exchange and complementing state exchanges can still make a huge difference.