The Clinton Herald, Clinton, Iowa

AP story section

November 13, 2013

Medicaid is health overhaul's early success story

WASHINGTON, D.C. — The underdog of government health care programs is emerging as the rare early success story of President Barack Obama’s technologically challenged health overhaul.

Often dismissed, Medicaid has signed up 444,000 people in 10 states in the six weeks since open enrollment began, according to Avalere Health, a market analysis firm that compiled data from those states. Twenty-five states are expanding their Medicaid programs, but data for all of them was not available.

Meanwhile, private plans offered through troublesome online markets are expected to have enrolled a much smaller number of people.

The Obama administration plans to release October enrollment statistics this week, but publicly available figures already provide a contrast between a robust start for Medicaid expansion and lukewarm early signups for new, government-subsidized private plans offered separately under the law.

“Medicaid is exceeding expectations in most places,” said Dan Mendelson, Avalere’s president. “It is definitely a bright picture in states that have chosen to expand.”

A big reason for the disparity: In 36 states, the new private plans are being offered through a malfunctioning federal website that continues to confound potential customers. And state-run websites have not been uniformly glitch-free.

Obama’s health care law melded two approaches to advance its goal of broader insurance coverage. Middle-class people with no access to job-based coverage are offered subsidized private plans, while low-income people are steered to an expanded version of Medicaid in states accepting it.

Starting Jan. 1, the law expands Medicaid eligibility to those with incomes up to 138 percent of the federal poverty level — $15,856 for an individual or $32,499 for a family of four. The Supreme Court gave states the right to opt out of the expansion, which is fully financed by Washington for the first three years, gradually phasing down to a 90 percent federal share.

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