Many Obamacare Shoppers Aren’t Actually Buying

Medicaid, not private insurance, is getting the bulk of early state enrollments

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It’s not clear how many Americans have secured new health insurance through Obamacare — the federal government won’t disclose initial figures until November. But some states have released preliminary numbers and a look at the early statistics shows that the vast majority of people who have managed to navigate the sign-up process in some states have enrolled in Medicaid, not private health plans.

The Affordable Care Act allowed states to expand eligibility for Medicaid, and about half have done so, meaning millions more Americans now qualify for the public insurance program. It’s also likely that many people who previously qualified but never signed up for Medicaid may be enrolling amid the Obamacare publicity blitz.

About 13 percent of those who’ve signed up for new coverage in Washington State, where the state-run insurance exchange appears to be operating fairly well, have enrolled in private plans; the rest were added to the Medicaid rolls. In its first week-and-a-half of operation, Connecticut’s exchange enrolled about the same number of people in Medicaid as in private health plans. And in Kentucky, more than half of all new enrollees signed up for Medicaid.

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The Congressional Budget Office has estimated that some 7 million people will sign up for private health coverage through the federal and state insurance exchanges by the end of 2014 and about 9 million will be added to the Medicaid rolls during the same period.

Figuring out which new enrollees fall into each category is not easy. Some state exchanges allow enrollment in Medicaid as well as private plans while others only offer the latter option, leaving Medicaid enrollment to other state agencies. And many officials have been tight lipped about numbers. The troubled federal exchange handling enrollment for more than 30 states isn’t releasing enrollment figures until next month and states that have publicly provided numbers are sharing a variety of different metrics that are not easy to compare. Some states have reported the number of people whose identity has been verified, making them eligible to apply for coverage and federal subsidies to cover some of the cost of coverage, while some have also reported the number of people who have taken a further step and applied for private plans. A third category reported by some states are the number of people who have actually enrolled in plans.

This last category and the total new Medicaid enrollees are ultimately the only numbers that matter. Since the bungled launch of Obamacare’s insurance exchanges, the White House has been touting overwhelming interest — going so far as to blame high demand for many of the federal site’s technical malfunctions. But browsers only matter if they translate into buyers, or, in the case of Medicaid, enrollees. And the White House hasn’t said how many of those there are.

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