State-run and partnership exchanges spent far more on outreach and enrollment efforts than the federal exchanges, according to analysis.
Researchers from the Robert Wood Johnson Foundation and the University of Pennsylvania's Leonard Davis Institute of Health Economics called the spending differences "striking" when analyzing the exchanges in a new report out Wednesday. State-run exchanges, on average, spent $17.15 per uninsured person, about three times more than the $5.42 spent by federal exchanges, to get the word out about signing up for coverage under the Patient Protection and Affordable Care Act.
The highest spending, however, was among partnership states — Delaware, New Hampshire, Arkansas, Illinois and West Virginia — which invested an average of $31.53 in consumer assistance per uninsured resident.
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The 16 state-based exchanges, and the District of Columbia, received 50 percent of the federal funding for consumer assistance, while the 29 federally facilitated exchanges received 33 percent, despite the fact that 63 percent of the nation's uninsured reside in those states, researchers said.
Though enrollment fared better for state-based exchanges, researchers said that success cannot be solely attributable to spending on uninsured outreach.
"The availability of federal money and the type of marketplace were huge factors in the amount states spent to enroll the uninsured," said Katherine Hempstead, who leads coverage issues at the Robert Wood Johnson Foundation. "The real question, which can only be answered in time, is how big of a role states' consumer assistance programs played in overall enrollment success."
Researchers from the University of Pennsylvania's Leonard Davis Institute of Health Economics said the large variations between the state and federal exchanges were a result of "funding eligibility and the type of assistance programs offered. State-based exchanges were in charge of funding and selecting navigator organizations, which allowed them to allocate funds more freely."
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