Washington state has been very pro-active about implementing the Affordable Care Act (ACA), or Obamacare. Washington is one of only 15 states to establish a state health insurance exchange. The other 35 states plan to use the federal exchange, which has been plagued by glitches and major problems. Medicaid expansion is a huge part of Obamacare and will be administered through the state exchange. The legislature never took a formal vote on the Medicaid expansion. Instead legislators simply put the expansion in the last budget as a line-item and passed this massive entitlement through the back door.
So, how is our state exchange doing?
State officials just released the most recent figures. A total of 211,000 people have made applications. Out of that number, 150,000 signed up for Medicaid, with no out-of-pocket cost. Of the remaining 61,000 who signed up on the private insurance side, only 18,000 have paid the initial premium and 43,000 have made application but have not put any money down.
In other words, 89% of people who have completed the exchange application have signed up for the Medicaid entitlement without any cost to them. Only 11% have signed up on the private side of the exchange. This is a very worrisome trend and hasn't changed since October. For Obamacare to work financially, the exchanges must have young, healthy people sign up on the private side. If they don't , the ACA becomes a huge, costly entitlement expansion and redistribution of wealth.
The exchange rollout has had other adverse effects on Washington families. Thousands of calls to the 1-800 number have gone unanswered. Two of the largest hospital systems in the Puget Sound area, Childrens and Swedish, have been excluded from government approved insurance plans in the exchanges.
And, is the Medicaid expansion a good deal?
The ACA is written such that ultimately 90% of the new Medicaid expansion is paid for by federal taxpayers. Of course, state taxpayers are the same people as federal taxpayers. So actually Washington state taxpayers will be forced to pay for the entire expansion, or $17-$22 billion over 10 years, depending on enrollment.
The real problem is that having Medicaid health insurance is not better than being uninsured. A recent study from Oregon, reported in the New England Journal of Medicine, confirmed that in a randomized, controlled study, Medicaid patients had no better health outcomes, nor did they live longer than a similar group of people without health insurance.
So while Washington state officials are promoting the supposed benefits of Obamacare, 290,000 people in Washington have received health insurance cancellation notices and have been forced to find a new, and in many cases, a more expensive plan.
The Obamacare rollout has been anything but smooth in Washington state. And we are suppose to be one of the successful states. Unfortunately, with a 2,700-page, partisan, centrally-planned law, this tragedy was predictable.