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Delaware health insurance

State sees incremental gains under Obamacare

The health status of residents as well as prevailing political attitudes about access to care and medical insurance coverage can affect your perception of a state. Find out what factors may shape your opinion of Delaware with this summary of public health rankings and health care reform.

Delaware health ratings

Delaware is ranked 15 by the Scorecard on State Health System Performance 2015, down from 10th in the 2014 rankings. The scorecard compares a large range of health indicators to arrive at an overall score for each state and the District of Columbia. See Delaware’s scorecard for the state’s performance on individual measures including avoidable hospital use and cost, healthy lives, access and equity.

When the 2014 edition of America’s Health Rankings was released, Delaware slipped to 35th – the state held position 31 in 2013. While Delaware’s strengths include high per capita public health funding and immunization coverage among teens, along with a low incidence of pertussis (i.e., whooping cough), it faces challenges with high rates of violent crime, infant mortality and diabetes. From 2013 to 2014, obesity in the state increased by 15 percent, and 31 percent of its adult population was considered obese.

The Scorecard on State Health System Performance and America’s Health Rankings evaluate different indicators. America’s Health Rankings consider more prevention and treatment indicators, on which Delaware received generally high rankings. That difference helps explain the disparity in the overall scores between the two evaluations.

The 2015 edition of Trust for America’s Health also provides a wealth of public health information, but does not provide an overall score. See Key Health Data About Delaware.

Finally, you can see county-level health rankings for Delaware from the Robert Wood Johnson Foundation and the Population Health Institute at the University of Wisconsin.

Delaware and the Affordable Care Act

In 2010, Delaware’s U.S. senators both voted “yes” on the Affordable Care Act while the state’s lone representative voted against the law.

Gov. Jack Markell supported the passage of the Affordable Care Act and spoke out to applaud the June 2012 Supreme Court decision that upheld most provisions of the ACA. Shortly after the Court’s ruling, Markell announced the state’s plan to operate its health insurance marketplace as a partnership with the federal government.

While some states chose the partnership model as a stepping-stone to a state-run marketplace, Delaware opted for a partnership model as the best balance between control and cost given its small population and potential market size.

How did Obamacare help Delawareans?

A January 2014 report by the Kaiser Family Foundation projected that the state’s decision to expand Medicaid under the ACA meant about 29,500 of Delaware’s 72,000 uninsured residents (41 percent) would qualify for Medicaid or the Children’s Health Insurance Program (CHIP). Another 15,840 uninsured residents (22 percent) were estimated to be eligible for premium tax credits to help them purchase health insurance through the marketplace.

A 2015 Gallup poll showed that Delaware’s uninsured rate dropped slightly from 10.5 percent in 2013 to 9.9 percent in the first half of 2015. A U.S. Census Bureau report released in 2015 provided lower numbers still, with 9.1 percent uninsured in 2013 and 7.8 percent uninsured in 2014.

Delaware enrollment in qualified health plans

In Delaware, 14,087 people enrolled in a qualified health plan (QHP). At 29.1 percent, Delaware ranked 15th among the states and the District of Columbia in terms of the percentage of the estimated total market that actually signed up for QHPs during 2014 open enrollment.

As of June 30, a total of 23,163 Delawareans had enrolled in Obamacare plans for 2015. Of those enrollees, about 84 percent were receiving advanced premium tax credits and 44 percent were receiving cost-sharing reductions.

For the 2016 coverage period, state residents enrolling in QHPs through the state’s partnership exchange can choose from health plans offered by two insurers: Highmark Blue Cross Blue Shield of Delaware and Aetna.

Delaware’s exchange has received thousands of dollars in federal grants to fund in-person assistance for 2015 and 2016 enrollment. Marketplace guides are available at more than 70 locations throughout the state. Delaware’s health insurance marketplace is called Choose Health Delaware; however, residents use to enroll in coverage.

Delaware Medicaid/CHIP

Delaware is among the states that expanded Medicaid under the Affordable Care Act. More than 11,200 Delawareans were deemed eligible for Medicaid or the Children’s Health Insurance Program (CHIP) during the ACA’s initial open enrollment.

From 2013 to July 2015, Delaware Medicaid enrollment grew by 18,000, or 8 percent – a significantly smaller increase than in other states where Medicaid had expanded.

Enrollment in Medicaid and CHIP continues throughout the year. Visit the Delaware Division of Medicaid and Medical Assistance website for information about the state Medicaid program and the Delaware Healthy Children Program.

Other ACA reform provisions

While Delaware has embraced many aspects of the Affordable Care Act, no organization in the state engaged in the Consumer Operated and Oriented Plan (CO-OP) Program. The CO-OP program offered loans totaling nearly $2 billion to encourage the startup of nonprofits to increase competition in the individual and small-group insurance markets.

In fall 2015, several CO-OPs announced their closure or intent to close at the end of the year, and several others are predicted to follow.

Medicare in the state of Delaware

Delaware Medicaid enrollment is about 17.34 percent of its total population; the percentage of enrollees nationwide is 16. Of the state’s Medicare beneficiaries, 82 percent qualify based on age alone.

There are about 20 states that spend $10,000 or more per Medicare recipient each year, and Delaware is among them, spending about $10,421 per recipient. The state ranks 44th in overall Medicare spending with $1.5 billion per year.

Delaware residents can enroll in private Medicare Advantage plans instead of Original Medicare. These plans offer additional benefits beyond traditional Medicare coverage. In 2014, about 7 percent of all Delaware Medicare recipients selected a Medicare Advantage plan, compared with 30 percent nationwide. However, 47 percent of the state’s enrollees selected a Medicare Part D plan for standalone prescription drug coverage, a number that lines up with the national average.

Delaware health reform

Here’s what’s happening legislatively with healthcare reform in Delaware:

  • As of June 15, 2015, HHS issued conditional approval for Delaware’s plan to transition from a state-federal partnership exchange to a federally supported state-based marketplace. However, in August, the state officially decided to continue with the state-federal partnership model, citing cost-effectiveness as the reason.

Other state-level health reform legislation: