Most of the news since the federal health insurance exchange opened on October 1 has focused on its pervasive technical problems and the ensuing confusion, the Republicans saying “we told you so” and the once-supportive Democrats who have been put in a bind.
But buried under the technological failures and the politics are the impressive numbers coming out of states who have taken proactive measures to expand health insurance coverage under the Affordable Care Act and are now seeing huge growth in their insured populations.
Read about other states' efforts and results and how Texas stacks up after the jump.California is blowing other states out of the water. In its first month, California's health insurance exchange (called Covered California) not only outpaced other state exchanges in terms of enrollment, but actually enrolled more people than the HealthCare.gov website did. According to the executive director of the state exchange, close to 31,000 people in California enrolled in plans in October and another 29,000 enrolled in the first nine days of November. On top of this 60,000, another 72,000 residents have been deemed eligible for Medicaid under the state's expansion.
Even Kentucky, one of the reddest of the red states, is running a state exchange so successful that it's enrolling about 1,000 people per day. Close to 85 percent of these enrollments are in Medicaid, which was also expanded in the state.
Meanwhile in Texas, fewer than 3,000 people were enrolled for health insurance in October. That's about one tenth of the number of people who enrolled in California, even though Texas and California's number of uninsured are fairly close (Texas had 6.1 million and California had 7.3 million as of 2011).
Of course, part of this is due to the frustrating shortcomings with the federal exchange. And Texas actually fared relatively well among states in terms of enrollment through the federal exchange – only Florida enrolled more people with 3,571. But had Texas taken advantage of more of the options available under the ACA (as California or Kentucky did), tens of thousands of uninsured Texans could have been enrolled already.
In fact, of the 106,000 people who signed up for health insurance in October, only about one-fourth signed up through HealthCare.gov, while the rest signed up through the fourteen state-run exchanges. If Texas had expanded Medicaid or chosen to run its own health care exchange, we could have been on par with some of these other states. As it is, with the highest uninsured rate in the country and having taken no proactive or corrective steps, Texas will only fall farther behind.