February 13

Disparities seen in enrollments under the Affordable Care Act

An analysis shows huge differences among the states, with most lagging and a dozen ahead by wide margins.

By Ricardo Alonso- Zaldivar
The Associated Press

And Kevin Vineys

WASHINGTON — Most states are still lagging when it comes to sign-ups under President Obama’s health care law, but an Associated Press analysis of numbers reported Wednesday finds a dozen high-achievers getting ahead of the game.

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Health and Human Services Secretary Kathleen Sebelius greets visitors after a Feb. 3 news conference on enrollment in affordable health coverage in Cleveland.

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Huge disparities are emerging in how well states are living up to federal enrollment targets, and that will help determine if the White House reaches its unofficial goal of having 7 million signed up by the end of March, six weeks away.

Connecticut is the nation’s top performer, signing up more than twice the number of residents it had been projected to enroll by the end of January. Massachusetts, which pioneered the approach Obama took in his law, is at the bottom of the list having met only 5 percent of its target.

Six Republican-led states – Florida, Idaho, Maine, Michigan, North Carolina, and Wisconsin – are on pace or better. Residents are signing up despite strong political opposition to the health care law in some of those states.

The administration said Wednesday about 1 million people signed up for private insurance under the health law in January, extending a turnaround from early days when a dysfunctional website frustrated consumers.

January marked the first time since new health insurance markets opened last fall that a national monthly enrollment target was met.

All in all, from Oct. 1 through Feb. 1, nearly 3.3 million people have signed up.

“It’s very, very encouraging news,” said Health and Human Services Secretary Kathleen Sebelius. Still, the goal of 7 million by the end of March seems like a stretch.

Also, officials are unable to say how many of those who signed up were previously uninsured – the ultimate test of Obama’s hard-fought overhaul. And they don’t know how many have sealed the deal by paying their premiums.

The numbers showed an uptick in the number of young adults signing up, now 25 percent of the total. Officials expect a last-minute surge of 18-34 year olds before the end of open enrollment on Mar. 31. Their premiums are needed to help with the cost of care for older adults. Overall, 4 in 5 of those signing up were eligible for financial assistance with their premiums or out-of-pocket expenses.

“Enrollment will continue to increase because it’s easier to sign up,” said Lynn Blewett, director of the State Health Data Access Assistance Center at the University of Minnesota. “What everybody hopes is that we see more young people and families with young children enrolling, to give the insurance pools a healthy mix of younger and older people.”

While the national numbers are improving, the latest report raises questions about what’s going on in the states. Ultimately Obama’s law will play out differently in each state, since insurance premiums are set at the local level.

The AP’s analysis compared the latest cumulative sign-up numbers for each state with targets spelled out in a Sept. 5, 2013 memo to Sebelius that the AP obtained months ago.

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