Close to 600,000 residents enrolled in private health coverage and Medicaid in the first year of the state insurance website, and Washington state leaders gathered Wednesday to mark the performance of this key provision of the Affordable Care Act.
At the gathering in downtown Seattle, U.S. Sen. Patty Murray, Gov. Jay Inslee and other state officials gave speeches worthy of Oscar recipients, thanking President Obama and the bipartisan support of local leaders, their employees and the legions of community partners that helped people enroll statewide.
In the six-month open-enrollment period that ended in March, more than 164,000 residents bought insurance through the state’s Washington Healthplanfinder online exchange, with 78 percent of them receiving a tax credit to help pay for it, according to a report from the Washington Health Benefit Exchange released Wednesday.
An additional 423,000 people used the site to sign up for Medicaid, known in Washington as Apple Health; more than two-thirds of them were adults newly eligible under the program’s expansion, while one-third had been eligible in the past but had not applied for coverage.
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Add in more than 416,000 who renewed or adjusted existing Medicaid coverage through the site, and a total of nearly 1 million people used Healthplanfinder to take care of their health-insurance needs.
“Washington state is leading America at having one of the best health-care-reform efforts,” Inslee said.
Michael Marchand, the exchange’s communication director, said, “It blew me away” that more than 1 million people went through Healthplanfinder since it began on Oct. 1.
Before then, “this thing didn’t even exist,” Marchand said.
But officials also acknowledged the work ahead. Many of the insurance sign-ups came from easier-to-reach customers: Women made up 54 percent of the enrollments, and one-third of enrollees are in the 55-to-64 age demographic.
To make the program sustainable in the long term, the state needs to enroll hard-to-persuade populations, including young, healthy residents who are cheaper to cover and who would apply downward pressure on premium costs.
In this first round, 25 percent of those buying insurance were in the coveted 18-to-34 demographic, below the 28 percent President Obama cited recently as the national figure.
The state ran ad campaigns specifically targeting younger residents, and the efforts appeared to boost the younger group’s enrollment numbers toward the end of the sign-up period.
“We’re going to be evaluating our outreach,” Marchand said. “We realized we weren’t going to get everyone in the first six months, and we’ve softened the ground pretty well with some key populations.”
The majority of people signing up for insurance in this first enrollment period are those who reported themselves as white, followed by Asian and Pacific Island residents. Some 9 percent of enrollees are ethnically Hispanic.
Whites are also the largest group enrolling for Medicaid, followed by black / African-American residents. Roughly 22 percent of Medicaid enrollees are ethnically Hispanic.
Speakers on Wednesday touted the cost of insurance bought through the exchange’s website. With more than 78 percent qualifying for financial help, the reduced price of an insurance plan fell on average to $107 a month.
“We said it would be affordable, and I think that’s affordable,” said Richard Onizuka, the chief executive of the exchange.
In total, Washington residents qualified for nearly $35 million in federal tax credits.
Additionally, people who bought “silver plans” — middle-of-the-road plans that cover 70 percent of the cost of essential health benefits — also may qualify for subsidies to help pay for out-of-pocket expenses such as copays. More than half the enrollees purchased silver plans.
About 37 percent of the coverage sold went toward “bronze plans,” which have lower premiums, but higher deductibles. That means these customers often must spend thousands of dollars on medical bills before the coverage kicks in for many services.
Onizuka hopes that as people begin to better understand how insurance works, they’ll realize the trade-offs between premiums and deductibles and move to plans with more generous benefits.
As it was, the state partnered with roughly 200 organizations for outreach and education, in part through navigators who were specially trained to help people enroll. About 89 percent of the people helped by the navigators signed up for Medicaid, while 11 percent bought insurance, suggesting the state may need to change its partnering strategies to boost insurance numbers.
Washington signed up twice as many newly eligible Medicaid participants as it had hoped to reach but fell short of its original insurance sales goals by tens of thousands of enrollees.
Residents also purchased insurance outside of the exchange, either through brokers or directly from insurance companies. The state has not released updated totals for these enrollees. Officials also don’t yet know how many people buying insurance were previously uninsured.
There were plenty of technical bumps along the way, and some remain. The exchange is still processing from 10,000 to 15,000 applications trapped in the system as a result of problems in verifying the applicant’s eligibility or other issues.
Other highlights from Wednesday’s report:
• Premera Blue Cross’ plans, including its subsidiary LifeWise, accounted for about 60 percent of the plans sold.
• Women were the majority of enrollees, topping men 54 to 46 percent in private health plans and in Medicaid newly eligible categories.
• Single adults were the largest family category, at more than 75,000 enrollees in private plans; the next group, families of two, counted 28,225 enrollees in private plans. Families of four and more totaled about 2,250 enrollees.
• The group with the most enrollees (more than 48,000 — nearly 32 percent) in private plans consisted of people 55 to 64. By comparison, enrollees in the 18-to-34 age group made up about 25 percent at just under 39,000.
• About 67 percent of those who began an application on Healthplanfinder finished enrolling in either Medicaid or a private health plan.
• The customer-support call center handled nearly 2.5 million calls, almost 74,000 of them in Spanish.
Meanwhile, insurance companies already are facing another deadline — May 1, when they must submit plans and prices for 2015.
“The work doesn’t stop here,” Murray said. “But it is great to stop for just a moment and recognize how far we have come.”
She also made clear that it was a victory the state would not relinquish, despite ongoing attacks from Obamacare opponents.
“We aren’t going back,” she said. “We’re not going to let any Republicans repeal this law and take health care away from millions of Americans, certainly not here in our state.”
This story was produced through a partnership with Kaiser Health News, an editorially independent part of the Kaiser Family Foundation.
Lisa Stiffler, a freelance writer in Seattle, can be reached at firstname.lastname@example.org. Carol M. Ostrom is at email@example.com or 206-464-2249. On Twitter @costrom.