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Health care enrollment on track to meet federal targets

Lawmakers expand Medicaid, thousands more eligible for federal coverage

Following the Dec. 31 federal deadline for health care coverage registration, approximately 32,000 Rhode Islanders have signed up for health insurance using the HealthSource R.I. marketplace. Over 20,000 people — approximately 63 percent of enrollments — have signed up for Medicaid, which puts Rhode Island roughly two-thirds of the way to meeting the original projection made by state officials. And over 11,000 have enrolled in private insurance plans, far ahead of federal enrollment targets, the Providence Journal reported.

“Rhode Island’s exchange has been working well since day one and will continue to do so,” said Ira Wilson, professor and chair of the Department of Health Services, Policy and Practice. He credited the program’s success to Lt. Gov. Elizabeth Roberts and former Health Insurance Commissioner Christopher Koller, among others.

In December alone, the number of Rhode Islanders enrolled in Medicaid nearly quadrupled.

As of Dec. 28, Rhode Island had reached 174 percent of its federal enrollment target of 12,000 sign-ups by March 31. The New York Times ranked Rhode Island second in its ranking of state-run exchanges.

Ninety-seven percent of people who enrolled in private insurance opted for a Blue Cross Blue Shield of Rhode Island private plan that is subsidized by the federal government.  About 87 percent of Rhode Islanders who have purchased private health insurance qualify for federal subsidies.

Rhode Island is one of 18 states that chose to create its own health care marketplace instead of utilizing the federal option, which has suffered significant technical difficulties since its Oct. 1 opening.

HealthSource R.I. collaborated with different state agencies and insurance companies to determine what marketplace would work best for Rhode Islanders, said Angela Sherwin ’07 MPH’09, director of the Executive Master of Healthcare Leadership program.

The exchange was successful from the start because the state was set on creating its own marketplace and hired smart people to do so, Wilson said.

Rhode Island also chose to expand its Medicaid program under the Affordable Care Act. The expansion provides Medicaid coverage to all adults with an income of up to 138 percent of the poverty line. As a result, an estimated 45,000 Rhode Islanders became newly eligible.

“Rhode Islanders are lucky to live in a state that chose to expand the Medicaid program for low-income adults,” Sherwin said.

The exchange also aims to make coverage more affordable and accessible to small businesses, Sherwin said. “Each individual employee can go to the exchange and pick which insurance plan works best for them,” she added. “Creating value for small employers is something that HealthSource R.I. did that was really intentional, and it makes Rhode Island stand apart.”

Over 70 small businesses have already signed up for coverage, according to the HealthSource R.I. website.

HealthSource R.I.’s “anonymous browsing feature” — which allows customers to explore specific plans without full registration — was one idea that had a much greater impact than expected, Sherwin said. The feature allows the exchange “to streamline customer inquiries in an efficient way,whereas other states have had web traffic bottlenecks,” she added.

After the Dec. 31 deadline passed, the rate of sign-ups in Rhode Island did not decrease, Sherwin said. “Interest will continue to grow through the next couple of months until the next deadline hits at the end of March,” Sherwin added. If people are uninsured by the March deadline, they will have to pay a penalty of $95 the first year. The fee increases to $695 by the third year.

Health care experts originally predicted that enrollments would not happen until after February because holiday spending could discourage people from paying premiums, Wilson said.

“Everyone expects there’s going to be an absolute flurry in sign-ups in March,” Wilson said. “People are indecisive and don’t make decisions until they are forced to.”

“While overall I think HealthSource R.I. is doing great, there’s still a long way to go to enroll uninsured” Rhode Islanders, Sherwin said, adding that the exchange has plenty of room to grow in the coming months.

The state needs to continue to work on ensuring that young people “understand the value of health insurance,” said Linda Katz, policy director and co-founder of the Economic Progress Institute and chair of Rite Care Consumer Advisory Council.

Wilson said he is interested in the ultimate cost of the program for consumers. Such costs will be hard to determine, because while more people are going to have regular exams done at the doctor’s office, fewer people will be ill down the road, he said. There are “downstream savings that you can’t see at the beginning,” Wilson added.

Federal funding toward the exchange will end in 2015, and state lawmakers are currently deciding how to fund HealthSource R.I. Christine Ferguson, director of the exchange, said the marketplace’s annual budget should be between $17 million and $20 million.

On Tuesday, four businesses — the Rhode Island Business Group on Health, Rhode Island Manufacturers Association, Rhode Island chapter of the National Federation of Independent Business and Greater Providence Chamber of Commerce — collectively signed and sent a statement to Gov. Lincoln Chafee ’75 P’14 P’17 stating that HealthSource R.I. should be funded not by state taxpayers but only by people and businesses purchasing insurance through the marketplace.


A previous version of this story misstated the name of the policy director and co-founder of the Economic Progress Institute and chair of Rite Care Consumer Advisory Council. Her name is Linda Katz, not Lisa Katz.



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