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Originally published April 1, 2014 at 8:24 PM | Page modified April 1, 2014 at 8:54 PM

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146,000 buy health insurance on state exchange

While the number fell short of the official goal, the state was overwhelmingly successful in signing up people who recently became eligible for Medicaid as a result of the program’s expansion under Obamacare.


Special to The Seattle Times

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Thanks to a crush of last-minute applications, more than 146,000 people purchased health insurance through Washington’s new marketplace before the Affordable Care Act’s first open enrollment closed at 11:59 p.m. Monday.

The number was less than state officials initially hoped for, but they seemed satisfied, if not entirely celebratory.

“We’re pretty pleased with that,” said Richard Onizuka, chief executive officer for the Washington Health Benefit Exchange, which operates the Washington Healthplanfinder exchange. We try to remember “each of those numbers is a person.”

The state had hoped to enroll 130,000 people by Jan. 1 — a goal it didn’t reach until last week.

While the number of people purchasing insurance was more modest, the state was overwhelmingly successful in signing up people who recently became eligible for Medicaid as a result of the program’s expansion under Obamacare.

More than 268,000 newly qualified people have enrolled in Medicaid, called Apple Health in Washington — twice the state’s goal and a number it hadn’t expected to reach until 2018.

Besides the newly eligible enrollees, an additional 135,000 people signed up who qualified for Medicaid under the previous, more stringent rules but had not already enrolled.

And the Medicaid enrollments will keep rising. These numbers are only through March 27, and people who qualify for the free health-care program can sign up throughout the year.

When you add up everyone using Healthplanfinder, which includes the folks buying insurance and people signing up for or renewing their Medicaid coverage, more than 960,000 people have enrolled in health care through the site since its launch Oct. 1.

Nationally, the White House tweeted by midday Tuesday that more than 7 million people and counting had signed up for private insurance coverage through government exchanges nationwide. That number beats the Obama administration’s original target, which recently had been revised downward.

The number of enrollees should keep growing as straggling applications move through the system.

Initially, Washington state officials said only people with verifiable website problems would get more time to finish their applications.

Onizuka on Tuesday softened that stance.

“We’ll be pretty flexible in the process,” he said, “But the people still need to do a lot of things to get enrolled.” That includes choosing a plan and making the first premium payment.

“If they’re in the system, we’ll reach out to a lot of them,” Onizuka said. “If they think they’re in the system, they can reach out to us, and we can evaluate.”

Washington residents who were unable to finish enrollment because they stalled on the Healthplanfinder website or were unable to get through to the toll-free help center can request an extension by calling 1-855-923-4633 or emailing customersupport@wahbexchange.org.

People who get extensions and complete their applications will have coverage in 2014 and avoid a fine for being uninsured.

Exchange officials said Tuesday they didn’t know how many applications were stuck in the system, or how many people already had requested more time. They also had not set a deadline for how long the extensions would stretch.

The numbers released Tuesday give an initial idea of how the enrollment went, but important data are still to come. That includes the age of enrollees — did the sign-ups capture cheaper-to-insure 18- to 34-year-olds, or older, sicker residents?

The state also doesn’t yet know if the number of uninsured residents — estimated to be nearly 1 million people — has decreased or by how much.

Officials don’t know if people shopping on the exchange had previously been insured and either lost coverage or opted for new plans.

Enrollment will open again Nov. 15 for coverage that starts next January.

In the meantime, the state plans to recalibrate its insurance-enrollment projections. The initial targets — set nearly three years ago — were 130,000 participants by Jan. 1, 2014, and 280,000 by the end of the year.

In order to reach that year-end goal, the state would need to enroll in the final six weeks of this year nearly as many people as signed up during the entire six-month enrollment that just ended.

Now that the state has actual enrollment data to work with, it’s hiring Milliman, an international actuarial company that provided the initial goals, to set revised targets.

“In the next two to three weeks or four weeks, we’ll know better what we can project over the next couple years,” Onizuka said.

The goals matter because they are used to set a tax on insurance premiums and the amount insurance carriers must pay to fund the exchange.

And the number of enrollees could still go up, beyond the folks who get extensions. That’s because the window for signing up remains open to people who experience significant life changes, including getting divorced, moving to a new state, having a baby or losing a job. They can purchase insurance throughout the year under the “qualifying events” provision.

Enrollment likewise never closes for Medicaid.

That’s particularly important given that Washington is one of 26 states that elected under the Affordable Care Act to expand its Medicaid program. The qualifying income is now 138 percent of the federal poverty level, which last year was close to $16,000 for an individual, or nearly $27,000 for a family of three.

Before insurance enrollment cranks up again, there is plenty of contentious, challenging work ahead.

State officials need to approve a new slate of insurance plans for 2015, and everyone expects a fight over which hospitals and doctors are covered. They must fix the exchange website to iron out glitches that frustrated many enrollees. They have to make sure information is accurately shared between the exchange and insurance companies. And they need to help people still stuck in the system.

“We’re trying to be the best exchange possible,” Onizuka said. “And really serve the people of Washington the best way we can.”

Lisa Stiffler, a freelance writer in Seattle, can be reached at lstiffler.work@gmail.com.This story was produced through a partnership with Kaiser Health News, an editorially independent part of the Kaiser Family Foundation.



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