JUNEAU, Alaska (AP) -- The rocky launch of the federal online insurance marketplace provided cover for those skeptical of Medicaid expansion, but the issues are separate, the regional director for the U.S. Department of Health and Human Services said Tuesday.
Susan Johnson, who is in Juneau for an Alaska Native Health Board meeting, said October and November — the first two months of the marketplace rollout — "were not our brightest moments."
"I think there's no doubt that there are some people who had such a bad experience in October that they won't come back (to enroll). I mean, I just have to be honest with that," she said in an interview with The Associated Press.
She said others might not have a computer or may feel uncomfortable with the world of insurance. "But of those numbers, I think people will come back because they will hopefully hear, 'This is the time I need to do it and I could get it (health insurance) for even nothing out of my pocket or very little,'" Johnson said.
Alaska is one of 36 states that has relied on the federally run website to provide access to individuals to shop for insurance to help meet requirements of the federal health care law. The site, while working better now, was plagued by problems after its Oct. 1 launch. About 50 Alaskans signed up during the first month; more than 3,300 signed up during the first three months, with more than 80 percent receiving federal help in paying their premiums. Updated numbers are expected soon.
March 31 marks the end of the current open enrollment period, and Johnson said there is an outreach effort underway, including in rural areas in the coming weeks.
Johnson said she doesn't think the amount of money Alaska received for "navigators" to conduct outreach and help promote the marketplace was adequate. Funding was based on a formula for population size but Alaska faces challenges in its remote communities, people living "off the grid," and lack of infrastructure that other states do not, she said. She said she has advocated for a stipend that would account for that but hasn't been successful.
Johnson expects another surge of activity on the online marketplace in March that could result in longer wait times. She encouraged people waiting to enroll to not put it off and reach out for help if needed.
For individuals allowed to keep their existing plans for an extra year, there is expected to be an enrollment period for new plans, that meet requirements of the law, later this year, she said.
On the issue of Medicaid expansion, while she acknowledged there is a trust issue, she said states can approach expansion cautiously, trying it for a year, seeing if the trust holds.
In states that have opted for expansion, the federal government is expected to cover the cost for the first three years, through 2016, and the bulk of the cost indefinitely, with the states contributing. Alaska House and Senate Democrats recently introduced legislation that would extend Medicaid eligibility to those up to 138 percent of the federal poverty line. State participation would depend on the federal government paying at least 90 percent of costs, the lowest level to which they are currently expected to fall.
Gov. Sean Parnell last fall declined to expand Medicaid under the health care law, citing cost concerns. Members of the state's GOP-led House majority have also questioned whether the feds would hold up their end of the deal if Alaska expanded Medicaid.
Johnson said Republican governors in other states have gone ahead with expansion. She said she hopes that happens in Alaska, "where the politics move aside for the people who are really suffering."
- Health Care Policy