The five states that managed to keep Obamacare enrollment costs the lowest per person were actually among those that most strongly opposed the health care law, according to a new report.
“The five states with their lowest cost-per-enrollee are all states whose governors and/or legislatures have resisted the ACA, and whose Attorneys-General challenged the constitutionality of the ACA,” wrote Jay Angoff, a former Health and Human Services official who worked under outgoing secretary Kathleen Sebelius.
Florida, Texas, Georgia, Virginia and Michigan produced the five lowest enrollment costs per sign-up, according to Angoff’s report for Washington, D.C. law firm Mehri and Skalet.
When the states’ sign-up numbers were compared to HHS’ total spending on the exchange itself, Florida had the lowest cost at $76 per sign-up. Texas came to $102 per person; Georgia, $240 per person; Virginia, $376 per person; and Michigan at $427 per person.”
Meanwhile, the top five exchanges with the highest totals per sign-up included three Obamacare supporters and two that opposed it. The top two most expensive exchanges, Hawaii and Washington, D.C., have leaders who support the health care law.
The whopping total that Health and Human Services spent creating the exchanges came out to almost $7.4 billion. About half of that went to just 14 state exchanges and Washington, D.C. — the total for all state-run marketplaces was $3.87 billion. The federally-run exchanges, covering 36 states, cost $3.52 billion to build and begin enrollment.
While state-run exchanges have been drastically more costly per state, a good number of them are failing entirely. Oregon has already opted to give up on its state-run exchange and allow the federal government to run the Obamacare program through HealthCare.gov instead. HHS spent $303 million on Oregon’s exchange by itself, bringing it to a total of $4,419 per sign-up.
Massachusetts has also given up on its exchange — which previously functioned just fine under Romneycare — hoping to create a new state-run program, with the possibility of jumping onto HealthCare.gov if it isn’t ready in time for the next open enrollment period.
Even Massachusetts, though, with its health care exchange expertise, spent $5,681 per person to sign up 31,695 people for coverage. The state received $180 million from HHS to make its Romneycare exchange Obamacare-compliant.
Hawaii’s exchange, which along with Massachusetts, Oregon and Maryland has been in the top five worst state exchanges, cost by far the most, coming in at a whopping $23,899 per person.
Washington, D.C.’s exchange had the next highest per-enrollment costs at $12,467 per sign-up. Unsurprisingly, the District approved this week a tax on all health insurers operating in the city to pay for its struggling exchange.
The most cost-efficient exchanges were all run through HealthCare.gov, a sign of their opposition to the health care law. A possibility for their success could be lower spending on extras that failed to help people sign-up for coverage.
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