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February 1, 2014
February 1, 2014 | Updated: February 1, 2014 10:24pm
SAN ANTONIO — In the four months since the launch of the federal health insurance marketplace, more than 47,000 Texans have tried to enroll in Obamacare, only to be told their low incomes qualified them instead for Medicaid. Since then, just 110 people have been enrolled in Medicaid or the Children's Health Insurance Program, state records show — .02 percent of those who were told they qualified.
The federal system is supposed to take the information collected and send it to Texas, where state officials determine whether participants are indeed eligible. But what should be a flood of transfers has instead been a dribble.
So far, Texas has rejected 130 applicants and 160 applications are pending. What happened to the remaining 46,600? Federal officials say computer problems have prevented state Medicaid agencies, including Texas, from receiving referrals from the federal system. Tens of thousands of applications are stuck in the pipeline, said state Health and Human Services Commission spokeswoman Stephanie Goodman.
“We're concerned that there are people in Texas who were told by the marketplace that they were eligible for Medicaid or (Children's Health Insurance Program) coverage, but they don't yet have coverage,” Goodman said. “In most cases, the marketplace hasn't been able to send us the information we need to get those people enrolled. In some of the cases they have been able to send, the marketplace made a mistake in saying the person qualified.”
As of Friday, the state had received 7,451 applications passed on from the marketplace and half were duplicates. State officials are starting to review the ones that weren't duplicates.
The federal marketplace opened Oct. 1. By the end of December, nearly 274,000 Texans completed coverage applications, with 47,177 determined to be eligible for Medicaid or the Children's Health Insurance Program.
Officials for the agency overseeing the marketplace couldn't explain why it mistakenly has found some people eligible for Medicaid. In a written statement, they said they are trying to improve transfers to state Medicaid agencies. Meanwhile, they are urging applicants to go to their state Medicaid agencies to enroll in the program.
“These approaches are aimed at ensuring that all consumers who are eligible for Medicaid coverage will receive Medicaid coverage,” officials said.
No one from Gov. Rick's Perry would comment on the problem. Perry, an outspoken Affordable Care Act opponent, declined to establish a state-run health insurance marketplace. He also has refused to expand Medicaid to cover an estimated 1.5 million uninsured Texans. Current rules make it difficult for Texans to get Medicaid; a parent with two children must earn less than $308 a month to qualify for the program.
Marketplace technical problems have tormented consumers, insurance enrollment counselors and insurers since its launch. Persistent glitches with the marketplace's healthcare.gov website made it nearly impossible to use until mid-November after a series of repairs were made. Consumers were frustrated. Lawmakers demanded the resignation of Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, who apologized for the marketplace's poor rollout.
Meanwhile, back-end computer problems have lingered, making it difficult for insurers and state Medicaid offices to get information supplied by consumers trying to enroll in coverage.
Texas Republican lawmakers, including Rep. John Culberson of Houston, have said the federal health care law is flawed at its core and have called for President Barack Obama to let it die. Culberson said the bottleneck of Medicaid cases is a result of the marketplace's poor execution.
“Given the administration's incompetence in launching the HealthCare.gov website, it is not at all surprising that (the Centers for Medicare and Medicaid) is slower than they should be in reviewing the eligibility of Texans for Medicaid and (the Children's Health Insurance Program),” he said.
In Texas, health care and insurance agencies and advocacy organizations have been meeting to ensure those who have enrolled in coverage, including Medicaid, are getting it.
Dr. Laura Guerra-Cardus, associate director of the Children's Defense Fund - Texas, said leaders knew Medicaid referrals were trickling in from the marketplace. However, she said she was unaware the state has received thousands of duplicate Medicaid applications, bogging down the process.
“My biggest question is why is (the marketplace) determining some people are eligible for Medicaid and Texas is not,” Guerra-Cardus said.
Like Goodman, Guerra-Cardus said she's troubled thousands of people who could be eligible for Medicaid might be waiting for coverage.
“The process should be as seamless as possible,” Guerra-Cardus said. ”The ones who really need coverage are sticking in there because they don't have any options.”
Houston's Patricia Fuller is among the thousands of Texans who the marketplace has found eligible for Medicaid. Fuller, who said she never has applied for Medicaid coverage for herself, has an interview Monday with the state Medicaid office to confirm her eligibility.
Fuller, 45, said she hasn't worked since she was fired in 2010 from her fast-food job. She got in trouble for bringing her daughter, who is autistic, to work after she couldn't find anyone to care for her. They live with Fuller's mother on the city's northeast side, living on about $665 a month.
Earlier this month, Fuller called the marketplace phone center to begin health insurance enrollment. The call center operator told Fuller she qualified for Medicaid after calculating her income.
“Are you sure?” Fuller asked, requesting a double check. “Medicaid.”
Although her eligibility hasn't yet been confirmed, Fuller said she's confident it will be.
“I'm a positive person,” she said. “I know it's going to work.”
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