Washington Medicaid enrollments surpassing expectations

With two months to go, Washington residents are pouring by the thousands through the online gateway to 2014 health insurance coverage, blowing away expectations for Medicaid enrollments, the expanded government program for the working poor and their children.

In Spokane County, one in four residents relies on Medicaid coverage.

Nathan Johnson, director of policy planning and performance for the state Health Care Authority, said the statewide sign-ups mean “there’s a tremendous amount of demand, and maybe more than we realized, for affordable coverage from those who are at or near the poverty level.”

Even though the state’s planners tried to forecast the need, they had “very limited experience with coverage expansion of this magnitude,” Johnson said.

The Affordable Care Act of 2010 opened two doorways to health coverage: Buy it through online exchanges, where private insurance carriers compete for the public’s business, or sign up for Medicaid through the exchanges. The exchange websites automatically route people to Medicaid if they fall within the low-income guidelines.

Until this year, most Medicaid patients were children. States and the federal government shared the cost of coverage.

Under the expansion, Medicaid covers more adults as well, whose income is up to 138 percent of poverty level, with the federal government footing the bill for the expansion. But expansion is optional under the law, and many Republican-dominated states, including Idaho, turned it down. Washington accepted.

Now that opening-day technical glitches largely have been resolved, Washington’s Health Plan Finder website has been racking up big numbers, according to data collected by the Health Benefit Exchange, which operates the site. The statewide totals through Jan. 30 include:

• 88,071 private health plans purchased on the site. Another 87,524 people finished their application and qualified for a private 2014 plan but have not yet paid.

• 172,715 newly eligible adults signed up for Medicaid. That’s 27 percent more than the state had expected by April 1. Another 84,372 Medicaid sign-ups were for people had been eligible before the expansion but had not applied.

In Spokane County, where the median household income is $49,615 and many families earn considerably less, demand for Medicaid has been stronger than anticipated: 15,239 newly eligible adults have signed up for Medicaid, 70 percent more than the state had expected by April 1.

Today, the state estimates 125,500 adults and children are on Medicaid in Spokane County. That’s 26.6 percent of the population.

More than likely, these enrollments will grow. There is no sign-up deadline for 2014 Medicaid coverage; people can qualify at any time.

Similarly, people already on Medicaid must reapply for it on their annual eligibility date, which can fall at any point on the calendar. The state mails out a notice when that date is drawing near. All Medicaid sign-ups now go through the state’s Health Plan Finder website.

But there is a deadline — March 31 — for people who wish to sign up at that site for a private 2014 health insurance policy.