The Washington Post

Tracking the abysmal success rate of the federal health-care exchange


The Affordable Care Act gave states the option of creating their own online health-insurance exchanges or defaulting to a federal site to help uninsured Americans obtain coverage before the law’s individual mandate kicked in.

Generally, the states whose political leaders opposed the health-care legislation refused to develop their own exchanges, leaving uninsured residents to seek coverage on the federal site.

With some well-documented technical problems plaguing the federal exchange, those resistant states are now faring worse on average than their compliant counterparts in terms of enrollment numbers.

The Post used data from the Department of Health and Human Services to create an interactive graph that illustrates the numbers, including eligibility rates, application totals, and success rates for those who have tried to enroll through the various exchanges. (Note: The HHS data covers a period ending Nov. 2, so the numbers may have changed in some cases).

A few takeaways:

1.) Eligibility is high, with a majority of applicants in most states qualifying for a plan on the exchange. That’s not even counting coverage under Medicaid or CHIP.

2.) Only a fraction of applicants who are eligible for coverage on the exchanges have successfully enrolled in a health insurance plan.

3.) Oregon, Maryland and Hawaii have the worst applicant-to-total-population rate, but the combined states relying on the federal exchange fall right behind them.

Follow Josh Hicks on TwitterFacebook or Google+. Connect by e-mail at  josh.hicks@washpost.comVisit The Federal Eye, The Fed Page and Post Politics for more federal news. E-mail with news tips and other suggestions.

Josh Hicks covers Maryland politics and government. He previously anchored the Post’s Federal Eye blog, focusing on federal accountability and workforce issues.



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Josh Hicks · November 22, 2013

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