With the official enrollment period now over, Obama administration officials are shifting their focus to getting people signed up for health insurance in other ways, targeting those who are eligible for Medicaid but have not yet enrolled and finding Americans, particularly young ones, who are allowed to purchase insurance plans after the deadline through a special provision in the law.
Medicaid enrollment is year-round, unlike the health care exchanges under the law, which had a deadline of March 31 for 2014 and will start enrolling people in November for insurance that begins in 2015. So officials from the U.S. Department of Health and Human Services are trying to get other states to borrow from an approach used in California, Arkansas and three states in which state governments target people who receive food stamps but are currently uninsured.
The states determine if the food stamp recipients are also eligible for Medicaid and, if they are, send notices to these individuals informing them that they can enroll in Medicaid either by signing an opt-in form included in the notice or calling a toll-free number.
Nearly 500,000 people in the five states have enrolled in Medicaid through this kind of “express lane,” as California has dubbed the program.
To target more young people, administration officials are looking at a part of the law that allows you to buy insurance outside of the official enrollment period if you have a “qualifying life event,” such as having a baby, moving to a new state or getting married. In particular, the administration and its allies plan to do outreach next month around college graduations, when students are often leaving their university health plans and changing states.
“We are using best practices of getting Americans signed up and applying them to the year-round effort to help Americans access health care,” said Tara McGuinness, a senior White House aide.
“When you add up people getting married, having babies …. changing jobs, that population ends up being fairly large,” said Saumya Narechania, national field director of Enroll America, a non-profit group closely aligned with the Obama administration that has staff in states all over the country dedicated to enrolling people in “Obamacare.”
This new push comes as the fortunes of the law are taking a turn in the administration’s direction. The 8 million people who enrolled from October to April exceeded the administration’s goal, and stories of people losing their insurance because of Obamacare or struggling to navigate its website are no longer dominating the headlines.
At the same time, the law remains controversial. Even as the administration seeks to expand the number of people in Medicaid, it faces one core challenge: 24 states, most with GOP-dominated legislatures or a Republican governor, have opted against expanding Medicaid to nearly all childless adults, as the law initially called for. Many conservatives have long opposed Medicaid and believe Americans should be steered into private health insurance.
GOP lawmakers in Louisiana last week rejected a provision that would have set up a ballot initiative so voters could decide if the state should expand Medicaid. Republicans in Virginia and the state’s Democratic governor, Terry McAuliffe, are so divided on the issue it could result in a shutdown of the state’s government.
Leaders in these conservative states are very unlikely to adopt HHS’s proposal to streamline Medicaid enrollment, because they are opposed to the program’s growth under the ACA in the first place. Obama administration officials are hopeful that a few states, such as Virginia and Utah, will expand Medicaid over the next year but acknowledge others, like Texas, may hold out for much longer, perhaps even after Obama leaves office in 2016.
Follow theGrio.com’s Political Editor Perry Bacon, Jr. on Twitter @perrybaconjr