There are growing signs that Obamacare's Medicaid expansion is a victim of its own success, unable to keep up with demand.
Image from Flickr via jikatu
By Charles Ornstein
By arrangement with ProPublica
Last week, federal health officials celebrated two milestones related to the Affordable Care Act. The first, which got considerable attention, was that more than 7 million people selected private health plans in state and federal health insurance exchanges. The second, which got less attention, was that some 3 million additional enrollees had signed up for Medicaid and the Children’s Health Insurance Program (public health insurance programs for the poor), many as a result of Medicaid’s expansion.
But there are growing signs that Obamacare’s Medicaid expansion is a victim of its own success, unable to keep up with demand. While about half the states have refused to expand their Medicaid programs’ eligibility, among those that have, some can’t process applications fast enough.
“I’ve heard getting an actual Medicaid card is nearly impossible. It’s like getting Willy Wonka’s Golden Ticket.”
Media reports from New Jersey, Illinois and California (states that have expanded their Medicaid programs) show that hundreds of thousands of consumers who may qualify for new Medicaid coverage aren’t getting it.
So what’s happening?
In Illinois, the Chicago Tribune reported last month that there’s a backlog of more than 200,000 applications waiting to be processed.
Much the same thing is happening in New Jersey, the Star-Ledger reported last week.
Federal officials conceded some of the blame for the delay can be put squarely at the feet of the federal website, healthcare.gov. That website transferred data about applicants whose income looked like they might qualify for Medicaid to the state system, but in a format the state system couldn’t use.
“The problems are getting fixed, but what worries people is that we’re only a few months away from next year’s open enrollment, so we have to hurry.”
And in California, the backlog now numbers 800,000 for Medi-Cal, the state’s Medicaid program, the Los Angeles Times reported this week.
A state spokesman told the paper that “the volume of Medi-Cal applications, combined with challenges of new computer systems, hampered the state’s ability to complete eligibility reviews in a timely and accurate manner.”
Matt Salo, executive director of the National Association of Medicaid Directors, said many of the problems relate to the way HealthCare.gov transfers information to states about consumers who appear to qualify for Medicaid based on their incomes. But there are state-specific issues, as well.
“It’s been the number one issue of concern for our members for the past nine months or so,” he said in an email. “The problems are getting fixed, but what worries people is that we’re only a few months away from next year’s open enrollment, so we have to hurry.”
Charles Ornstein, in collaboration with Tracy Weber, was a lead reporter on a series of articles in the Los Angeles Times titled “The Troubles at King/Drew” hospital that won the Pulitzer Prize for Public Service, the Robert F. Kennedy Journalism Award and the Sigma Delta Chi Award for public service in 2005. His ProPublica series, with Tracy Weber, “When Caregivers Harm: California’s Unwatched Nurses” was a finalist for a 2010 Pulitzer Prize for Public Service.
Ornstein reported for the Times starting in 2001, in the last five years largely in partnership with Weber. Earlier, Ornstein spent five years as a reporter for the Dallas Morning News. He is a past president of the Association of Health Care Journalists and a former Kaiser Family Foundation media fellow.