Next up: Medicaid expansion meltdown

For those of you being entertained by the Obamacare disaster, I've got good news. Pop some more popcorn, sit back in your chair and watch the meltdown that will occur when the Medicaid expansion begins on November 1.


A new phase of the Obamacare launch is coming, this one involving Medicaid. And it could be déjà vu all over again.

On Nov. 1, the health law's malfunctioning enrollment system is supposed to send reams of data to states so they can begin placing thousands of people into Medicaid. But state officials say that transfer system has barely been tested and could be vulnerable to technical failures like those that have crippled the broader Obamacare sign-up process.

"We're flying blind on what the process is," said Kathleen Nolan, state policy head of the National Association of Medicaid Directors. "There hasn't been the capacity to do a lot of the testing. ... There's a natural concern that with a major load of data to be sent all at once - there is concern that what has been tested may not be able to handle the volume."

It's a challenge for state governments, and people trying to sign up for the low-income health care program could be left unsure of their coverage status.


Marilyn Tavenner, who runs the Centers for Medicare & Medicaid Services, on a conference call with states Tuesday did not offer a timetable for a full repair, according to Matt Salo, executive director of the National Association of Medicaid Directors. The date was already postponed once, from Oct. 1.

Nolan said some people managed to sign up on the flawed website only to be told to reach out to their local Medicaid agencies to finalize enrollment. But the local Medicaid offices can't confirm anything because the applications haven't been transferred.

"People are getting a little confused," Nolan said.

A federal Medicaid spokeswoman said the Obama administration has delivered a basic snapshot of the Medicaid-eligible population to help states get a sense of the numbers so they can plan.

But that so-called flat file includes only names and addresses, not nearly the level of data state Medicaid programs need to process applications.

Under Obamacare, millions of low-income uninsured people are expected to enroll in Medicaid, which will be expanded significantly in about half the states on Jan. 1. Plus, the health law's enrollment push is expected to bring out of the woodwork people who are currently eligible but haven't already signed up for Medicaid. Early data from states running their own enrollment systems are reporting tens of thousands of new Medicaid enrollees so far this month, a potential indicator of strong interest.

There are now 25 states that have agreed to expand their Medicaid programs - most of which will be dependent on the website to help process initial enrollees. What are the chances of a smooth rollout?

Vegas probably didn't even bother to post odds.

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