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The other health exchange snarl

By Jay MacDonald · Bankrate.com
Tuesday, January 7, 2014
Posted: 6 am ET

Millions of uninsured and underinsured Americans breathed easier once they were able to access the government's new online health insurance exchange HealthCare.gov last month, following a massive overhaul to better handle the online demand.

But that massive traffic jam has yet to clear for eligible low-income folks who've been trying without success to access health coverage through Medicaid or the Children's Health Insurance Program (CHIP) on the federal exchange.

Medicaid limbo

Due to technological disconnects between state Medicaid networks and HealthCare.gov, which serves as the default exchange for 36 states, the applications of tens of thousands of Medicaid-eligible applicants remain in limbo.

Federal officials knew this stampede was coming. An estimated 9 million Americans were expected to qualify for coverage under Medicaid and CHIP in 2014, thanks to the Affordable Care Act. But software problems continue to block the smooth hand-off of applicants from HealthCare.gov to their state Medicaid sites after their eligibility is confirmed. The 14 states that built their own health exchanges have been spared this problem.

How bad is the back-up? According to Kaiser Health News, about 105,000 applicants in five states (Arizona, Florida, Illinois, South Carolina and Texas) remain stalled, waiting for the bridge between HealthCare.gov and their state Medicaid program to open. Medicaid officials in those states say that so far, they've been unable to enroll anyone directly from the HealthCare.gov site, much less in "real time."

Resorting to old-fashioned printouts

While federal officials say they're working on opening the electronic span and are planning to make coverage for those who've applied retroactive to Jan. 1, applicants who require health care services in the meantime stand to face yet another record-keeping roadblock.

Federal officials have gone old-school to remedy the immediate need by offering states a computer printout of residents who have signed up for Medicaid and CHIP via HealthCare.gov so they can contact the applicants in question to have them complete the process. Unfortunately, the information forwarded to the states isn't always complete, and the prospect of contacting thousands of applicants by phone with limited manpower has proved daunting.

Officials say the best course of action for those who qualify (or think they might qualify) for the government safety net programs is to forgo the federal exchange for the time being and instead apply (or complete their HealthCare.gov application) directly through their state Medicaid site.

If there's one bright spot in this midwinter traffic snarl, it's that there is no enrollment deadline for Medicaid or CHIP.

Follow me on Twitter: @omnisaurus.

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