Some states have been signing people up for Medicaid through their online exchanges, while other states have instructed people to contact Medicaid offices directly to enroll.
In Washington state as of Oct. 20, 31,000 out of the more than 35,000 people who have enrolled for coverage through its online exchange have enrolled in Medicaid, said Jim Stevenson, spokesman for the state's Health Care Authority, which runs the state Medicaid program. Of those who have enrolled in Medicaid, more than 19,000 became newly eligible under the expansion, while more than 11,000 were previously eligible but hadn't signed up for Medicaid coverage.
According to Stevenson, Washington began running a marketing campaign in September to raise awareness about the health exchange. The strategy included television ads as well as outreach, with as many as 3,000 community-based volunteers trained to help with Medicaid enrollment.
“I think the outreach definitely helped,” Stevenson said. “We have about a million uninsured Washington residents, and we've only started three weeks into a campaign to get them into coverage, so there's a long way to go.”
Stevenson said the state expected Medicaid enrollment initially to be higher than private plan enrollment. But he stressed it's still early in the process and that the state expects the enrollment numbers to even out between the two programs by the time open enrollment on the exchange ends March 1, Unlike people signing up for private plan, those who qualify for Medicaid can enroll year-round
“We have 16,699 (applicants for private plans) who have gone through the [application] process but they haven't paid the money (yet),” Stevenson said. “I think there is clearly a large body of shoppers who are looking at what's available to them but not quite ready to commit.”
In Oregon, a new “fast-track” enrollment process for its Medicaid program is being credited for signing up nearly 56,000 in the first two weeks after the state exchange, Cover Oregon, opened. The state has so far not provided figures as to the number of people who have enrolled onto private plans through the exchange. Last week, Cover Oregon spokeswoman Ariane Holm said enrollment numbers would not be available until sometime in November.
Since late September, notices have been sent to as many as 260,000 residents who either are currently receiving benefits under the federal Supplemental Nutrition Assistance Program or have children enrolled in Medicaid. The notices inform them that they pre-qualified for health coverage beginning Jan. 1. The notice said they had the option to consent to enrollment by phone or by filling out a one-page form. Oregon Health Authority spokeswoman Patty Wentz said the result of the letter campaign has been a flurry of responses from people consenting to be covered.
“Our phones started ringing off the hook,” Wentz said. “Mail started pouring in, faxes started pouring in, and our call volume has been three times the normal level and it has remained strong.”
Wentz estimated as many as 75% of the state's Medicaid-eligible population qualified for fast-track enrollment. She said the mail campaign has helped to free up resources to do outreach to the remaining 25% of the eligible population.
Other states have seen similar Medicaid sign-up numbers. In Maryland, more than 82,000 people have enrolled in the state's expanded Medicaid program as of Oct. 19, compared with 2,300 estimated to have sign up for private insurance through the state exchange. In West Virginia, as many as 50,000 reportedly enrolled in Medicaid.