The Health Care Authority announced today that the Washington State Medicaid program enrolled 121,258 newly eligible Washington Apple Health clients by January 2 under an expansion of the federal-state program.
The new income threshold for adult Medicaid eligibility is 138% of the federal poverty level or $15,856 for a single individual and $26,951 for a family of three.
Medicaid expansion enrollment goals are based on estimates created two years ago with help from the Urban Institute and their nationally respected Health Insurance Policy Simulation Model.
Dorothy F. Teeter, Health Care Authority director, said average daily enrollment tallies for newly eligible adults have grown and stayed high as the HealthPlanFinder experience has improved for consumers.
“As we anticipated, there is significant demand from the uninsured for comprehensive medical coverage through Apple Health,’ she said. “This is early evidence of the previously unmet demand for affordable coverage in Washington, and continued success on this front will be essential for meeting the needs of nearly 1 million uninsured residents in our state.”
Original estimates have enrollment continuing to increase by an additional 58,000 newly eligible adults during 2014. The vast majority of new adult clients will be covered by 100% federal funding under the Affordable Care Act, the federal health care reform law passed in 2009.
Expanding Medicaid coverage to bring hundreds of thousands of Washington residents into the ranks of the insured was only one of the key health care reform accomplishments over the last year:
- Federal funds also were used to boost Medicaid provider reimbursements for primary care and family physicians to match rates paid by the Medicare program, an average 80% increase for most adult services.
- January 1, 2014, marked the first three months of operations for Washington State’s Health Benefit Exchange. The web portal – known as Washington Healthplanfinder.org – gave Medicaid and low-income insurance shoppers the ability to sign up for services electronically and have their income, taxes, Social Security status, and family size all verified automatically by linking up to federal and state databases.
- The quick and easy-to-operate Healthplanfinder cut the waiting time for enrollment from as long as 45 days to 45 minutes. Despite some anticipated glitches, the web portal operated with relatively few problems through the fall and early winter – especially by comparison to other state exchanges and the federal portal, Healthcare.org
- The reforms launched on January 1 also scrapped annual or lifetime caps on coverage, as well as erasing forever the ability of insurers to deny coverage for pre-existing conditions. An earlier rule had protected children against those practices.
Through the Medicaid expansion authorized under the Affordable Care Act, the program is opening its rolls to a new population of childless adults as well as many parents who do not meet very restrictive income and asset requirements. Previously, Medicaid has predominantly served children, pregnant women, people with disabilities, low-income elderly and low-income families.
The expansion also was an opportune moment for the Health Care Authority to apply a new Apple Health brand for all of its Medicaid programs. The new brand – Washington Apple Health – capitalizes on the successful children’s medical brand, Apple Health for Kids, which was adopted in 2008.
Despite meeting statewide enrollment targets for the Medicaid expansion, some areas of the state have underperformed county enrollment targets established on the basis of population, citizenship and income status for each county’s residents.
“We are interested in pursuing a Medicaid expansion that meets the needs of both rural and urban Washington and will be refocusing our efforts and partnerships with the community to ensure that the word gets out,” said MaryAnne Lindeblad, Medicaid Director. “We have not seen a coverage expansion of this magnitude in years, but are confident that a streamlined eligibility experience and considerable outreach with thousands of partners will both achieve our Medicaid expansion targets and get Washington covered.”
The 121,258 in new adult enrollments recorded between October 1 and the end of the year were less than half of the full 333,271 total Apple Health enrollments processed over the same period. That total represented some children and adult enrollees who were already eligible for Medicaid (55,807) as well as clients already enrolled who were using the new web portal to renew their Apple Health coverage (156,206).