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Health Insurance & Affordable Care Act

More Than 1.7 Million Consumers Still Wait For Medicaid Decisions

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The reasons for the problems include technological glitches that prevented the federal insurance marketplace from transferring data on applicants to state Medicaid agencies and many states’ inability to handle an enrollment surge because of inadequate staffing, their own computer problems and other issues.

Feds Say They Are Making Headway

Officials at the Centers for Medicare & Medicaid Services (CMS) say they have made progress and can now quickly transfer data on applicants to all but three states — Alaska, Kansas and Maine — one reason that enrollment in the program surged by 1.1 million people in April.

The agency “is actively transferring accounts to all states that are ready to receive them,” said spokesman Aaron Albright. “Every state not receiving transfers can be enrolling people through alternative options,” such as getting a spreadsheet of names and addresses of people who have applied to the federal marketplace, he said.

One reason that states such as New York and Washington have done better than others is that they modernized their Medicaid eligibility systems earlier than others, Dorn said. Other states such as Kentucky made sure their state insurance exchange could transmit data smoothly to their Medicaid program.

Medicaid is the workhorse of the nation’s health system, providing coverage to about one in 5 Americans. Twenty-six states have expanded eligibility under the health law to everyone with incomes under 138 percent of the federal poverty level, or about $16,100 for an individual. But even states that did not expand the program have seen increased demand for coverage, as people who were previously eligible but not enrolled tried to sign up as a result of publicity around the new exchanges and requirements that most Americans have coverage.

Unlike applying for private insurance through the online marketplaces, which can be done only during a few months of the year, people can apply for Medicaid anytime.

While states are working through their backlogs, the next big test will come Nov. 15, when open enrollment for private plans resumes and spurs a surge in people applying for Medicaid. The enrollment system should be running smoother by then, most experts say.

Fri, Jun 06 2014

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