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Exchanges off to a Slow Start; Medicaid Expansion Continues

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Insurance exchanges were set to launch October 1, but technical glitches and enrollment delays have plagued most exchanges.

The most significant problems are occurring within the federally-facilitated exchange (FFE) site, making enrollment in 36 states virtually impossible. Although state exchanges experienced challenges, many have resolved those problems and others have provided timelines for when fixes will be complete. While this year’s 6-month open enrollment period offers flexibility to correct technical problems, the federal government, states, and vendors must work quickly to capitalize on public interest. In less than two weeks since launch, reports show 11.2 million unique website hits and 110,400 completed enrollments, for both the FFE and for state-based exchanges.

Final carrier participation information is now available across all 50 states, with an average of 6 carriers participating in each state. Premium rate information is available for all 34 FFE states, with average silver plan premiums for 50-year olds ranging anywhere from $335 to $619. Such premium ranges indicate that insurers in many states may be responding to competition through exchanges; however, the level of competition is highly varied depending on local market characteristics.

To date, 23 states will not pursue Medicaid expansion in 2014, while 24 states and DC will expand. Governors Corbett (R-PA) and Kasich (R-OH) recently proposed Medicaid expansion options, likely to take effect mid-2014. Meanwhile, Arkansas became the first state to gain CMS approval to implement a premium assistance-based approach to the Medicaid expansion.

This article was excerpted from the September issue of State Reform Insights, which highlights the impact of state ACA implementation activity on life sciences, providers and plans in one comprehensive monthly source. For access, contact Caroline Pearson.

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