By Ted Nesi
PROVIDENCE, R.I. (WPRI) – More than 20,000 Rhode Islanders have used the state’s new HealthSource RI Obamacare marketplace to sign up for Medicaid, the government insurance program for low-income Americans, WPRI.com has confirmed.
The number of Medicaid enrollments through HealthSource RI totaled 19,941 as of Wednesday, with an additional 1,500 sign-ups pending, David Burnett, chief of government and public affairs at the R.I. Executive Office of Health & Human Services, revealed Wednesday in response to a request from WPRI.com.
The number of Medicaid sign-ups on HealthSource RI roughly quadrupled in December, jumping from 5,280 to 19,941, amid a drumbeat of publicity about deadlines to get coverage under President Obama’s new health law.
State officials originally projected 28,000 people would sign up for Medicaid through HealthSource RI during the 12 months ended Sept. 30, which puts Rhode Island two-thirds of the way to meeting its projection with nine months to go, Burnett said. The state estimates 51,000 will enroll in Medicaid by March 2015.
“I think we’re going to meet the 12-month expectation for sure,” Burnett said.
HealthSource RI disclosed earlier this week that 11,305 individuals enrolled in private insurance plans through the agency between its Oct. 1 launch and Dec. 31. That would put the agency’s combined total three-month enrollment at almost 33,000. It’s not known how many of those people were previously uninsured.
Expanding Medicaid to cover all adults who earn up to 138% of the federal poverty level is a crucial part of how Obama’s Affordable Care Act proposes to expand insurance coverage in the United States going forward. The new eligibility rules took effect Jan. 1.
While the Medicaid program’s costs usually are split roughly 50-50 between the states and the federal government, the health law calls for the federal government to pick up at least 90% of the tab for newly eligible enrollees on a permanent basis, and 100% of the cost during the first few years.
Many Republican-led states have refused to expand Medicaid following a 2012 U.S. Supreme Court ruling that made it optional to do so, but Rhode Island and most other Democratic-run states have moved aggressively to expand the program and take advantage of the extra federal subsidy.
HealthSource RI estimated last year that about 64,000 Rhode Islanders would be eligible to enroll in Medicaid once eligibility expanded on Jan. 1, with 45,000 of them newly eligible because of the health law’s changes and another 19,000 of them previously eligible but not enrolled in the program for some reason.
Burnett was unable to say how many of the state’s roughly 20,000 new Medicaid enrollees became eligible Jan. 1 and will therefore be heavily subsidized by the federal government; if some of them were already eligible but had previously failed to sign up, they’ll come under the standard rules and thus will cost the state more.
“Even if we’re over our estimate at this point for people who enroll, the newly eligible are all 100% covered” by the federal government, Burnett said. “Doing too well in this case is getting more people to sign up right off the bat, and it isn’t financially disadvantageous to the state.”
Medicaid is already one of the largest parts of the state budget.
About 228,000 Rhode Islanders were on Medicaid at some point during the state’s 2011-12 fiscal year, or roughly 22% of the state’s population, at a total cost of nearly $1.8 billion. To put that figure in context, the entire state budget is $8.2 billion this year.
Individuals who are eligible for Medicaid can enroll in the program at any point during the year, and Burnett said early indications are that people are continuing to sign up at a steady pace this month even after the highly publicized December Obamacare sign-up deadline passed.
“There’s a tremendous amount of interest right now, which is good,” he said, adding: “It doesn’t feel like we hit a peak on Dec. 31 and it died off. It feels like we still have some pretty strong enrollment numbers, at least through January.”
Burnett said those who are enrolling in Medicaid through HealthSource RI are being put into managed-care plans through the state’s RIte Care program. Those Medicaid managed-care plans are run by two private insurers: UnitedHealthcare and Neighborhood Health Plan of Rhode Island. Some of the newly enrolled may eventually be moved to a different Medicaid program, Rhody Health Partners, which serves adults with disabilities, he said.
Neighborhood Health Plan spokesman Tom Boucher said the insurer added 9,100 new members through HealthSource RI from October through December, with 4,300 of them signing up for private plans and 4,800 of them signing up for Medicaid.
A spokesman for United did not immediately return a request for comment.
Burnett acknowledged there have been some “bumps” and “hiccups” for the new Medicaid enrollees due to the expansion and the launch of HealthSource RI, which has been struggling with high volume and technology problems in recent weeks. As an example, he said there was an issue with how HealthSource RI transferred information to Medicaid that affected about 3,500 people which has since been solved.
State lawmakers voted last year to reduce Medicaid eligibility for parents, from 175% of the federal poverty level down to 138%, in order to match the new health law’s provisions. Most of the roughly 6,500 individuals who became ineligible because of the change were automatically enrolled in one of Neighborhood’s private plans, and the state paid the premium for their first month, according to the Economic Progress Institute.
The Affordable Care Act requires all Americans to have health insurance or else pay a penalty starting next year. Open enrollment for private plans through the law’s new marketplaces for this year is currently scheduled to end on March 31. (Dec. 31 was the sign-up deadline only for coverage that kicked in Jan. 1.)
State lawmakers will be taking a close look at HealthSource RI in the coming months, particularly how to finance it. The agency is seeking an annual administrative budget of $17 million to $20 million, but so far no source of funding has been identified to cover the tab once federal startup funding runs out next year.