Thursday, December 14, 2017
Politics

PolitiFact: Too simplistic to say 500,000 signed up for Obamacare

A lot of numbers were thrown at us when the White House finally announced Nov. 13 how many individuals had signed up for health care coverage through online marketplaces. The general consensus, including from many Democrats, is that the early returns were underwhelming.

Still, there was a lot of confusion. How many successfully navigated through the error-laden federal marketplace website? Who actually purchased coverage? Where does Medicaid fit into all of this?

Rep. Debbie Wasserman Schultz, D-Weston, tweeted a simple breakdown.

"This week we found out 500,000 people have signed up for #Obamacare," the chairwoman of the Democratic National Committee said. "It's good news, but we have more work to do."

Is that an accurate overview, or did she oversimplify it?

The U.S. Department of Health and Human Services has the statistics:

• From Oct. 1 to Nov. 2, 1,509,883 people applied for coverage through a federal or state marketplace.

• Of those individuals, 106,185 approved applicants actually picked an insurance plan — 79,391 through a state marketplace and 26,794 through the federal marketplace.

• About a quarter of the people who applied, or 396,261, were told they were eligible for Medicaid or the Children's Health Insurance Program.

Wasserman Schultz's office said her tweet came by adding those who picked a private insurance plan to those deemed eligible for Medicaid. And it's true, adding those two figures together gets us 502,446.

But have those people "signed up for Obamacare"?

Obamacare is a complex law with many moving parts, not a single government program in which people enlist.

The Medicaid element in particular adds a perplexing twist. Medicaid is an existing state-federal health insurance program largely for the poor. The health care law allows states to expand Medicaid eligibility, and some states are doing that.

According to the Department of Health and Human services, about 400,000 individuals were "determined or assessed eligible for Medicaid or CHIP," but are they actually signed up? Does the applicant have to take additional steps to officially enroll, just as he or she must pick a plan after the application is processed?

The federal health department said they shouldn't have to. Instead, "the state Medicaid or CHIP agency takes additional steps to finalize an eligibility determination," according to a health department report.

In states like Kentucky, which run their own marketplace, it's pretty seamless.

For states operating under the federal marketplace, the process involves a bit more red tape.

In some states, Medicaid eligibility is determined by the federal marketplaces, and if eligibility is met the individual should be all set. In others, the final eligibility determination is left up to the states.

Florida, for example, opted out of the Medicaid expansion under Obamacare and chose not to operate its own marketplace. Some people applying through healthcare.gov are eligible for the state's existing program. For those people, a spokeswoman for the Florida Department of Children and Families said determining final eligibility will be "quick but not automatic."

But there's a delay in that process. The federal marketplaces do not yet have the functionality to transfer Medicaid eligibility data to the states. With 36 states relying on the federal government to run the insurance marketplace, that could push back Medicaid enrollment for thousands beyond Jan. 1 if it is not fixed in the coming weeks.

A final note: It's not clear how many individuals told they were eligible for Medicaid would have qualified even before the expansion of the program under Obamacare. Those numbers have not been released.

Wasserman Schultz said "500,000 people have signed up for #Obamacare." The numbers add up if you count different parts of the law that work together to expand coverage, but it's a little simplistic. The fate of many of the Medicaid enrollees remains up in the air due to the problems with the federal marketplace. We rate her statement Half True.

Edited for print. Read the full version at PolitiFact.com.

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