May 1—Despite political splits that produced sharply different enrollment efforts, California, Texas, and Florida obtained the largest enrollments in new government-run marketplaces, the latest federal figures show.

The 1.4 million California enrollments comprised more than 17 percent of the 8 million national enrollments in the marketplaces created by the Affordable Care Act (ACA), the U.S. Department of Health and Human Services (HHS) reported Thursday.

The final enrollment figures include the extended enrollment period HHS allowed through April 19, when more than 900,000 of the total signed up. Florida sign-ups totaled more than 983,000, and Texas garnered more than 733,000.

Important caveats on the latest figures include the acknowledgement of the Obama administration that they include an unknown number of applicants who never paid their premiums and whose policies were never activated. The House Energy and Commerce Committee concluded in a new report that one-third of marketplace enrollees failed to pay their premiums, which is more than the 10 to 20 percent found in some other studies. The Obama administration has sharply contested the Republican-led committee’s findings but has declined to obtain the figures from insurers.

Hawaii, North Carolina, and Wyoming had the fewest marketplace enrollments.

Demographic Details Emerge

Other exchange details that emerged from the latest report included that so-called young invincibles, whom the administration wanted to comprise 40 percent of the marketplaces to strengthen the marketplace risk pools, totaled only 28 percent of sign ups.

Among other findings, higher shares of African-American and Asian applicants qualified for coverage in the federal exchange than as eligible insured, while lower shares of Whites and Hispanics qualified for coverage in the federal exchange. Whites comprised 43 percent of applicants who selected a plan, while 31 percent were “unknown/other.”

Additionally, the Centers for Medicare & Medicaid Services (CMS) announced that more than 4.8 million additional individuals enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) from Oct. 1, 2013, through the end of March 2014. That figure includes previously enrolled beneficiaries and previously eligible people who signed up for coverage in both states that did and did not expand Medicaid eligibility, as allowed by the ACA.

Rich Daly is a senior writer/editor in HFMA’s Washington, D.C., office. Follow Rich on Twitter @rdalyhealthcare.


Publication Date: Thursday, May 01, 2014