Health Benefits Exchange Surge of Enrollments, Still Expensive

HealthSource RI has published its enrollment numbers from its opening to January 4, after the deadline to enroll for January coverage.  In continuation of our series putting the number in context, we herein present them with reference to the federal millions that taxpayers provided in order to create an online government broker for Rhode Island’s extremely limited health insurance options.

According to the Center for Consumer Information & Insurance Oversight, under the federal Centers for Medicare & Medicaid Services, the federal government has given $134.7 million in grants aimed, at least in part, at getting Rhode Island’s Affordable Care Act health benefits exchange, HealthSource RI, up and running. Of that, $99.1 million went directly to the Rhode Island government.

As the following chart shows, even with the last-minute rush for plans, U.S. taxpayers have spent $10,011 in direct grants for each of the 9,902 Rhode Islanders who have officially enrolled (having paid their initial premiums).

Adding in the 1,868 people who have completed the application but not yet paid an initial premium, the per-person subsidy decreases to $8,422.

The largest group of enrollees, however, includes the 24,252 Rhode Islanders who used the subsidized health insurance exchange to discover that they are eligible for free healthcare, through Medicaid or the state’s RIte Care program. (Rhode Island opted to follow the Affordable Care Act in expanding the categories of people who are eligible for Medicaid, to include able-bodied, childless young adults.)

That’s 67% of the 36,022 who have completed the application process, a percentage that’s unchanged from last month.  It’s impossible to know how many of those enrollees are new to Medicaid or were already eligible before the Affordable Care Act, but it would appear that the state is well on its way to the 41,185 new people dependent on the government for health insurance that the Kaiser Foundation predicted by 2019.  As the Center pointed out when the state was deciding how to respond to the Affordable Care Act, this expansion could cost Rhode Island taxpayers nearly $60 million per year (and almost half a billion dollars in state and federal spending).

On the other side of the spectrum, only 1,545 (like last month, 4%) are enrolling in plans without claiming additional taxpayer subsidies in the form of financial assistance on their premiums and other expenses.