October ACA Enrollment Numbers Released; Federal and State Health Care Exchanges Show Varying Levels of Success

On November 13, 2013, the House Oversight & Government Reform Committee held a hearing investigating the rollout of the federal health care exchanges. Administration officials answered questions from lawmakers on the problem-plagued rollout of the online exchange that covers 36 states. The administration also released the first set of enrollment numbers. About 27,000 signed up through the federal exchanges and 79,000 through the 15 state-based exchanges.

The numbers indicate the stark difference between the two groups of marketplaces. While the federal exchanges have gotten off to a wobbly start and continue to experience challenges, states have mostly been more successful.

In Washington state for instance, there have been 7,341 enrollments in private insurance plans since October 1, 2013, according to a November 4 press release. Like many other states, a much higher number of newly-eligible Medicaid Washington residents of 29,622 also enrolled. Similar ratios of high Medicaid enrollees to private insurance plans in Colorado, Minnesota, Kentucky, Maryland, New York and Connecticut were also reported.

In Indiana, a state with a federally-run marketplace, the state legislature agreed to extend the state's high-risk pool through the end of January 2014, out of concern that the federal website would still not be operational to the point of allowing residents to sign up for health insurance by January 1, 2014.

Even though the state-based and federal exchanges seem to be separate and distinct, they both rely on the same databases to verify identity and other data. Bottlenecks will affect both systems and need to be resolved for all exchanges to work effectively.