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Late Surge Spurs Higher-Than-Expected Obamacare Sign-Ups in Garden State

State’s ACA enrollment tops expectations, outpaces last-minute climb nationwide in March and April

New Jersey’s enrollment in the federal health insurance marketplace surged in March and April, outpacing the national increase and exceeding the expectations of healthcare analysts.

With 87,405 signups between March 1 and April 19, New Jersey more than doubled the number of state residents who enrolled from October 1 to March 1, bringing the total to 161,775.

The individual health insurance marketplace is one of the two primary ways that the 2010 Affordable Care Act, or Obamacare, increased access to insurance, along with an expansion in Medicaid eligibility.

The dysfunction of the marketplace website, healthcare.gov, during October and November kept New Jersey’s enrollment to only 4,000 in those months, but the site’s improved performance and a last-minute public-awareness campaign appeared to pay off.

“This is a very popular program here,” said Raymond J. Castro, senior policy analyst with New Jersey Policy Perspective, a nonprofit research organization.

Castro noted that according to the latest federal update, New Jersey’s ACA enrollment increased by 117 percent in March and April, compared with a national increase of 89 percent. Nationally 8.02 million people enrolled during the open enrollment period, which lasted from October 1 to March 31, with an extension into April for late filers.

U.S. Secretary of Health and Human Services Kathleen Sebelius attributed the success to an “unprecedented outreach” and public-education effort.

One group of New Jersey residents who may not have enrolled at a high rate were Latinos, who represented just 6.7 percent of the residents who identified their race or ethnicity when they enrolled; 17.7 percent of New Jersey residents identified themselves as Latino, according to the 2010 census.

On the other hand, 16.3 percent of New Jersey residents who enrolled identified themselves as Asian, nearly double their 8.3-percent share of the state population. White residents accounted for 62.3 percent of enrollees who listed their race, compared with 68.6 percent of the 2010 population, while African-Americans represented 13.2 percent of enrollees and make up 13.7 percent of the state’s population.

Castro noted that more than one-third of enrollees didn’t list their race or ethnicity, which may have skewed the numbers. At the same time, he said that reaching Latinos continues to pose a significant challenge. He added that the open enrollment period that just ended may prove easier than the next enrollment period, which starts on November 15.

It’s going to be important to do geographically targeted outreach efforts in areas with the highest number of uninsured residents, Castro said, “because, as we get further along, you have to start reaching the folks who have the most barriers.”

Those working to get the uninsured to sign up for coverage won’t let up in the down time between open enrollment periods, said Justine Ceserano, New Jersey state director for advocacy organization Get Covered America.

“This announcement is proof positive that people across New Jersey are hungry for the opportunity to have affordable, quality health insurance,” she said in a statement.

While advocates for wider healthcare access hailed the Obamacare enrollment increase, concerns remain. It’s not clear how many of those who enrolled will pay their monthly premiums. And even among those who do pay their premiums after they first enroll, some may drop coverage after they experience the high out-of-pocket costs of some plans.

Castro pointed out that even if 20 percent of the newly enrolled fail to pay their premiums, the state would still exceed enrollment projections.

The ACA requires nearly every American to have insurance, or else pay a penalty. The penalty is the greater of $95 or 1 percent of income this year, rising to the greater of $695 or 2.5 percent of income in 2016.

The insurance premiums for the plans offered in the next open enrollment period remain a major unknown. ACA critics have pointed to the comparatively low portion of enrollees who are young as a major problem, since insurance plans must have a mix of people with different health statuses to avoid charging high premiums.

But Castro said that having 25 percent of New Jersey enrollees between the ages of 18 and 34 would likely be enough to avoid a major increase in premiums in 2015. The percentage of younger enrollees rose steadily as the open-enrollment deadline approached, a pattern that was predicted by analysts based on the experience in Massachusetts, the first state to mandate insurance coverage.

Castro said he was also was encouraged by the fact that 84 percent of marketplace enrollees will receive tax credits to offset the cost of premiums. He noted that New Jersey was at nearly the same level as the 85 percent nationally, which he said was an accomplishment considering that the state has a lower share of low-income residents.

The tax credits are available for people with incomes between 100 and 400 percent of the poverty line, currently amounting to between $11,490 and $45,960 for a single person and between $23,550 and $94,200 for a family of four.

Citizens and legal immigrants who have been in the country for more than five years and have income below 138 percent of the poverty line are eligible for the Medicaid coverage expansion.

Through March, 102,000 New Jersey residents had been added to the state’s Medicaid coverage since the expansion.

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