A part of the HealthCare.gov website, photographed in Washington. If you have health insurance on your job, you probably don't give much thought to each year's renewal. But make the same assumption in one of the new health law plans, and it could lead to costly surprises.Despite Tennessee's decision not to expand Medicaid, the number of uninsured people in the state has shrunk by nearly a quarter in the first year since the new health insurance marketplace launched under the Affordable Care Act.
That brings the percentage of uninsured Tennesseans to its lowest level in a decade, a University of Tennessee at Knoxville report released Monday found.
"It's a significant decline, but not necessarily unexpected given the implementation of the ACA this year," said the report's co-author, Dr. LeAnn Luna.
Last year, the university reported that out of the state's 6.5 million residents, about 611,000 were uninsured -- a rate of about 9.6 percent. But over the course of one year, that rate fell to 472,000, or 7.2 percent-- the biggest single drop since the university began collecting such data 20 years ago.
The report also shows that the rate of uninsured children fell from 3.7 to 2.4 percent -- a roughly 35 percent drop.
The report does not detail the reasons for the drop, but Luna said the awareness of new coverage through the Affordable Care Act undoubtedly drove a high number of people to apply for coverage through HealthCare.gov.
Some of those people purchased plans through the marketplace, while others found out that they were actually eligible for Medicaid under the state's existing rules -- even without Medicaid expansion. The dynamic has been called the "woodwork effect," or the "welcome mat effect."
The large volume of new applicants meant that TennCare, the state's Medicaid program, saw its third highest enrollment in the program's 20-year history.
That was in spite of TennCare application problems and months-long enrollment delays that have been reported since January. That was when the state began sending all Medicaid applicants to apply for the state program through HealthCare.gov, since Tennessee's own computer system was unfinished.
"The eligibility and enrollment process worked smoothly for the vast majority of applicants -- as evidenced by the near record-setting numbers of new enrollees," TennCare spokeswoman Kelly Gunderson said.
While some TennCare applications were delayed in the federal marketplace, Gunderson said, TennCare does "not believe this had a significant effect on overall enrollment growth." She added that the delays would have been an issue even if the state's unfinished computer system that was supposed to make eligibility decisions was up and running.
But state health advocates say the high enrollment numbers say otherwise. The director of one of three advocacy groups that has sued TennCare over application delays said that any improvement in the rate of insured residents is "thanks to the new federal law."
"Sadly, Tennessee is the only state that refuses to accept and process applications directly for [TennCare] coverage," said Michele Johnson, director of the Tennessee Justice Center. "If our state government had not turned its back on its own people, many more working families would have the economic security and peace of mind that comes with having health insurance."
Meanwhile, those who have been able to enroll in TennCare gave the agency a positive review. For the eighth year in a row, 93 percent of those surveyed said they were satisfied with the program.
The annual report -- which is done by UT's Center for Business and Economic Research -- compiles data about Tennesseans' insurance status and their satisfaction with TennCare, the state's Medicaid program.
Researchers interviewed about 5,000 heads of households by telephone between May and July, Luna said.
The UT report echoes data that ACA outreach nonprofit Enroll America released last month. That report showed that the uninsured rate fell by 2 to 3 percentage points across Tennessee -- including 3 percent in Hamilton County -- in one year, said Jacob Flowers, Tennessee state director of Get Covered America.
Meanwhile, the personal finance site WalletHub reported that Georgia's uninsured rate dropped by 3.5 percentage points since last year.
"With the new health insurance marketplace having opened last weekend and eligible consumers able to sign up for TennCare at any time, we're know that more uninsured Tennesseans will get covered in the coming months," Flowers said.
Contact staff writer Kate Harrison Belz at kbelz@timesfreepress.com or 423-757-6673.