10 states are critical to health plan
6M sign-up mark carries practical, political weight
Ten states — seven of them controlled by Republicans — hold the key to whether the Obama administration succeeds at signing up 6 million people for health insurance by the deadline of March 31.
Those large states account for nearly 30 million uninsured — almost two-thirds of the nation’s 47 million uninsured. And that is why the Obama administration and advocates have focused so much attention on California, Texas, Florida, New York, Georgia, Illinois, North Carolina, Ohio, Pennsylvania and New Jersey.
“It’s like what Willie Sutton said when they asked him why he robbed banks. ‘That’s where the money is,’ ” said Jonathan Oberlander, health policy professor at the University of North CarolinaChapel Hill. “The national figures are really being driven by just a handful of large states.”
Reaching the 6 million projected by the Congressional Budget Office has both practical and political significance. The more enrollees there are, the more likely the exchanges will have enough younger and healthier people to spread insurance risks and hold down premiums in future years.
And it gives Democrats poten- tial bragging rights — or another headache — heading into the November elections.
Sign-ups have been stronger than average in California, New York, Florida and North Carolina where there have been vigorous outreach efforts by states and voluntary groups, but have flagged in many other places.
California, with nearly 7 million uninsured — the highest number in the country — had enrolled 1 million people as of March 17, more than a quarter of those eligible for the marketplace plans in that state, according to the Kaiser Family Foundation.
But in Texas — where 6.2 million people are uninsured, almost a quarter of the state’s residents — the state declined to participate in the marketplace. As in most Southern states, officials have been openly hostile to the law. Fewer than 10% of those eligible had enrolled as of March 1.
Nationally, about 5 million people had enrolled in Obamacare plans by March 17, according to a blog post by Marilyn Tavenner, administrator of the Centers for Medicare & Medicaid Ser- vices. Millions more had started the application process but not chosen a plan.
Over the next two weeks, Obamacare supporters have hundreds of enrollment events planned in the 10 states, and top administration officials are expected to make more trips to Florida, Texas and Ohio.
State exchange directors are trying to put things in perspective. “This is about changing a culture that for too many low-income people is a culture of coping rather than a culture of coverage,” said Peter Lee, who runs the California exchange. “And that doesn’t change on a dime.”