States that operate their own health insurance exchange have lower rates of uninsured consumers than consumers that signup for new coverage or renew a policy on Healthcare.gov.
That’s the chief takeaway from new metrics just out from the U.S. Centers for Disease Control and Prevention. Another chief takeaway from the data is the rapid expansion of Medicaid—primarily in big states such as California—is the big reason for the drop in the uninsured rates among states that operate a health exchange. About half of all Medicaid is financed through the Centers for Medicare and Medicaid Services but is administered through state run programs.
State health exchanges also allow eligible consumers to sign up for Medicaid coverage, according to the U.S. Centers for Disease Control and Prevention. Overall states that did not rely on Healthcare.gov but used their own exchange had an uninsured rate of 8.3% compared to 16.1% among states that used Healthcare.gov as their e-commerce platform to sign up for and renew health coverage for consumers.
The CDC report provides the first federal summary of impacts of the 2017 open enrollment period. The report shows wide variation across the nation in the extent to which states have lowered their rates of the uninsured, with particularly striking differences between states that manage their own marketplaces and expanded Medicaid, and those that did not, the CDC says.
The biggest difference was in California. The CDC survey says states like California that expanded Medicaid had an uninsured rate of 8.8 % compared with 19% for states that didn’t operate an exchange or expand Medicaid.
In addition, in the first half of 2017, state-based marketplaces continued to make progress at reducing the number of the uninsured, from 8.6 % to 8.3%. The CDC used metrics from the 2017 open enrollment season that ended Feb. 1 to come up with its numbers. Overall and nationwide about 28 million consumers still did not have health insurance.
Other report findings include:
- States that operate their own marketplaces had an uninsured rate that was roughly half that of states that rely on the federally facilitated marketplace.
- California’s uninsured rate dropped to 6.8% in first six months of 2017, down from 17% in 2013.
- States that expanded Medicaid had an uninsured rate (8.8%) that was less than half the rate of states that did not (19%).
- These results from 2017 show that state-based marketplaces continue to reduce the uninsured rate in their states, while states supported by the federally facilitated marketplace showed increases in the number of the uninsured for the first time since 2014.
“California is not alone in the gains made possible by the Affordable Care Act,” says Peter V. Lee, executive director of Covered California, the state’s healthcare exchange. “This new survey shows that overall, state-based marketplaces continued to reduce the rates of their states’ uninsured, while those states supported by the federal marketplace saw the first uptick in their uninsured since 2014.”
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