WASHINGTON – Despite technical glitches, a government shutdown and dozens of attempts to repeal the new health care law, implementation of the Affordable Care Act is going strong in the country’s largest state, according to a new report.
The study, compiled by the Kaiser Family Foundation, indicates that 22 percent of those qualifying for coverage in California had enrolled as of Feb. 4, the fourth-highest percentage of all 50 states. If California’s sign-up rate were applied to every state, the number of Americans enrolling would total 6.3 million nationwide, about double what it is now, said Drew Altman, Kaiser president and CEO.
“If the rest of the states were doing what California is doing, then they’d be talking about the Affordable Care Act’s success,” Altman said at a news briefing Wednesday.
Although California is a leader in carrying out the health care law, state officials recognize how much work is still left to be done.
“California is certainly not ready to put a mission accomplished banner on the deck of our carrier here, but we have made progress,” said Diana Dooley, secretary of California’s Health and Human Service’s Agency.
California’s size and diverse population lends itself to case studies on implementing the ACA, the Kaiser Foundation and state officials said.
California has done a much better job of making the machinery of the new law work, compared to many other states that have struggled to enroll participants, said Ed Haislmair, senior research fellow at the Heritage Foundation, a conservative think tank.
But even with California’s success in implementing Obamacare, the Kaiser report fails to recognize the systemic flaws in the law, Haislmair said. If low-income workers are given a raise – and no longer qualify for Medicaid — their employers are required to find insurance coverage for them, or face a fine. That gives employers a huge incentive to keep their workers enrolled in Medicaid, according to Haislmair.
This would hinder younger workers’ ability to advance economically, he said.
According to Congressional Research Service, the Affordable Care Act includes potential employer penalties to ensure that companies continue to provide some degree of coverage to workers. The health care law has a “shared responsibility” provision where companies, in some instances, are required to offer health care for their workers or pay a penalty.
Haislmair said the biggest issue going forward is whether or not Medicaid will be expanded to cover low income, able-bodies workers — often young people.
In California, it is still difficult to reach the state’s low income population, officials said. Of the 7 million uninsured California residents, one-fifth are undocumented immigrants who do not have the ability to access health insurance under Obamacare, said Rachel Garfield, associate director of the Kaiser Commission on Medicaid and the Uninsured.
The state has been able to reach uninsured adults who previously had no contact with social and health services. But it is important to continue outreach efforts to get to high-need groups, the report found. Health centers and clinics will play an important role in reaching vulnerable populations, the report said.
Phil Schiliro, advisor for health policy and reform for the White House, pointed to the 3.3 million Americans who had enrolled by the start of the month and stories of life-saving care for previously uninsured individuals as indicators of the health care law’s success.
But national discussion of the enactment health care law has been “obscured” by the botched rollout of and technical issues associated with the online insurance exchange Healthcare.gov, Schiliro said.
“It’s having a very difficult time getting through the noise,” he said.
