Vital Signs

The Healthcare Business Blog

N.Y. exchange on target to meet enrollment goals

By Joseph Conn

The head of New York's health insurance exchange says her state is on track to meeting its long-term enrollment targets, but its numbers of enrollees already make it one of the most successful of the 14 states that launched their own online portals.

Though mid-December, officials of NY State of Health, as the Empire State's portal is called, say their site has processed applications from more than 363,000 New Yorkers, including 134,622 that have completed enrollment for coverage that is to start Jan. 1.

“We're seeing people qualifying for tax credits as well as people at full pay,” said Donna Frescatore, the executive director of NY Health Benefit Exchange, which runs the portal.

Frescatore said enrollment has been running about 55% signing up for private plans and 45% enrolling in Medicaid. But Frescatore said the state expects that ratio to end up closer to 70-30.

While New York is off to a fairly smooth start with enrollments under the Patient Protection and Affordable Care Act, it will be a journey of years, she said. There are about 2.7 million uninsured New Yorkers out of a total population of 19.6 million. But the state's projected enrollment at full implementation by the end of 2016 is 1.1 million. Divide the 39 months between then and the Oct. 1, 2013 launch date and “we're right on target” with enrollment figures to date, she said.

New York, which has fairly liberal Medicaid eligibility standards to begin with, estimates 75,000 additional New Yorkers will be eligible for Medicaid coverage because of the expansion of eligibility limits under Obamacare, according to a projection done for the state by the Urban Institute. The state also expects to enroll a significant number of the estimated 513,000 New Yorkers already eligible for Medicaid who haven't signed up.

Increased publicity about healthcare coverage because of the launch and controversy surrounding the troubled federal health insurance enrollment portal,, has boosted Medicaid enrollments in other states with their own exchanges.

Kentucky, for example, also a Medicaid expansion state, estimates that more than 640,000 its citizens (about 15%) are uninsured, and that nearly 97,000 have enrolled since its site opened Oct. 1. Of them, about 75% have enrolled in Medicaid with the remaining 25% in private plans.

Like the federal and other state exchanges, NY State of Health initially bogged under an unexpectedly large wave of early visitors when the site launched on Oct. 1, said Chris Harmer, leader of the team from Computer Sciences Corp., the prime contractor developing the New York site.

“The first three days we had response issues because the volumes were so high,” Harmer said. But by the Saturday following the Tuesday launch, “we increased our overall capacity fourfold,” pressing into service computers already onsite that were planned to be hooked up later to handle a volume increase expected before the December enrollment deadline for Jan. 1 eligibility.

Planning and close collaboration with state employees and information technology counterparts from 26 health and dental plans participating in the exchange were the keys to New York's success thus far, he said.

“You can talk about planning an awful lot, but in the end it's about people getting together as a team and making it happen,” Harmer said. Time was short on this project—work began in May 2012. “But we were successful here, and very proud of it. If it wasn't for Donna's team, it wouldn't have been successful and I'd like to say the same thing with the CSC folks.”

Harmer refused to speculate on why New York had early success while the federal site, performing the same tasks, floundered. “Not having the insight into what they went through, it's difficult to say anything,” Harmer said. “It's very difficult to do one state and be successful. I can't imagine what it would be to try to do 36.”

Follow Joseph Conn on Twitter: @MHJConn

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