This article originally appeared on watchdog.org.
OSAWATOMIE, Kan. — Kansas’ opposition to Obamacare has actually saved taxpayers money.
A breakdown of raw enrollment numbers and spending has revealed that, from a fiscal perspective, Kansas was probably right to reject a more than $31 million federal grant to set up its own insurance exchange.
The federal government spent about $1,331 for each of the roughly 57,000 Kansans who enrolled in Obamacare through the online insurance exchange at HealthCare.gov, according to lawyer Jay Angoff with the Washington, D.C., law firm Mehri & Skalet.
The figure stands in stark contrast to state-run exchanges like Connecticut’s, which spent more than $2,077 for each of its enrollees. Other per-person rates for state-based exchanges include Kentucky at $3,060, Oregon at $4,436 and Hawaii at a jaw-dropping $23,899.
“The big takeaway is that the federal exchange is much more efficient,” Angoff told Kansas Watchdog. “It costs a state much less to opt into the federal exchange than to establish its own exchange.”
Nationwide, the federal exchange averaged $922 per enrollee.
Angoff, a former Missouri insurance commissioner and one-time director of the Health and Human Services office charged with implementing the health care exchange program, said reaching the conclusion wasn’t hard. He snagged enrollment data provided by the U.S. Department of Health and Human Services, and Affordable Care Act spending figures from the Congressional Research Service.
From there, it was just simple math. Check out Angoff’s numbers here.
There is, of course, some variability. California’s state-based exchange was the only one to post a per-person enrollment cost of less than $1,000. However, while Florida’s federal exchange participation amounted to a miniscule $76-per-person figure, North Dakota’s average came to $7,089 for each of its nearly 10,600 enrollees.
Still, Hawaii’s cost absolutely takes the cake, and has sparked calls to shut down the state-run insurance exchange.
Linda Sheppard, the Kansas Insurance Department’s second-in-command on ACA-related issues, said the state agency doesn’t have a stance on Angoff’s figures. Sheppard did say she felt the biggest hindrance to increasing Kansas’ enrollment numbers — which would have lowered the per-person cost — was the scarcity of funds made available for outreach and education.
“However, considering the very small amount of dollars available for outreach I believe the navigator organizations operating in the state are feeling like they did the best they could with what they had,” Sheppard said.
Additional figures analyzed by Kansas Watchdog suggest increased funding may not have made a difference. While states operating their own exchanges poured millions of dollars into promotional initiatives, that didn’t necessarily result in more participation relative to the population size. Here’s a breakdown of that spending, and its resulting enrollment, for a handful of states analyzed in a report issued by the Robert Wood Johnson Foundation and the Urban Institute in March:
- New York: 370,451 enrolled (1.94% of population), $40 million for outreach
- Oregon: 68,308 enrolled (1.75% of population), $10 million for outreach
- Maryland: 67,757 enrolled (1.15% of population), $2.5 million for outreach
- Minnesota: 48,495 enrolled (.90% of population), $9 million for outreach
For comparison, here’s a breakdown of several states that opted to rely on the federal exchange, using federal dollars for promotions:
- Michigan: 272,539 enrolled (2.75% of population), $2.5 million for outreach
- Virginia: 216,356 enrolled (2.64% of population), $1.8 million for outreach
- Alabama: 97,870 enrolled (2.02% of population), $1.4 million for outreach
- Kansas: 57,013 enrolled (1.97% of population), $900,000 for outreach
Enrollment statistics were retrieved from Angoff’s report, while population percentages were calculated using 2012 census data. Outreach spending for Kansas was supplied by Sheppard.