Why is Medicaid getting most Kentuckians who have found insurance through the health exchange?

11/07/2013 10:33 AM

One of the biggest criticisms of Kentucky’s early returns from the state’s health exchange is that an overwhelming majority have landed on the government’s Medicaid program rather than private insurance.

But state officials say that’s to be expected early in the open enrollment period, which began Oct. 1 and ends March 31.

The reason the number of Medicaid enrollees is so much higher so far is because if someone’s income qualifies them to be on that program, they’re automatically signed up. It’s like a turning on a light switch.

Others who earn more than 138 percent of the poverty rate — $15,856 for an individual — can find private insurance through the exchange from either two or three companies depending on the area in which they live. But that process often takes longer so that people have time to mull over their options and the cost of the plan, said Gwenda Bond, assistant communications director for the Kentucky Cabinet for Health and Family Services.

As of this fall, Kentucky had 640,000 people who were uninsured. The latest numbers provided by the Health Cabinet show that 32,485 of those uninsured have enrolled in new health coverage. Here’s how those numbers break down:

308,000 of them are eligible for Medicaid now that it has been expanded to cover more low-income Kentuckians. And so far, 27,854 individuals have enrolled in Medicaid.

The other 332,000 uninsured Kentuckians make too much to qualify for Medicaid but could find health coverage with private and nonprofit insurers through the exchange.
But only 4,631 of those individuals have signed up so far — less than 1.5 percent of those who are expected to qualify.

Many of those looking to sign up for private insurance also have the ability to apply for government subsidies through the health exchange to help pay for their coverage if they make less than 400 percent of the poverty rate: $45,960 a year for an individual.


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