LANSING, Mich. - The four-year wait is nearly over for uninsured Michigan residents needing medical insurance through the 2010 federal health care law.
But when coverage kicks in starting Wednesday, it will be many more months or even years before a clear picture emerges of the law's impact in the state.
At most, just tens of thousands of residents will have picked a plan from the new federal health insurance marketplace in time for coverage in January. Many more will wait until getting closer to the end of open enrollment in three months, when many risk being fined for not having insurance.
And hundreds of thousands more newly eligible Medicaid recipients will have no choice but to wait because Michigan lawmakers delayed steering more poor and near-poor adults to the program until April. Medicaid enrollment then will be year-round.
Experts caution against reading too much into early enrollment numbers, citing the flawed insurance website that is working better -but which still has problems - and people's inclination to procrastinate or take their time when choosing a product costing potentially thousands of dollars a year. The Medicaid expansion postponement also has prevented the state and counselors from actively adding new enrollees in conjunction with the launch of the exchange.
"For the program ultimately to be a success, people who are currently uninsured and eligible for this coverage need to sign up. I don't think that needs to happen in the first year," said Larry Levitt, a senior adviser at the Kaiser Family Foundation.
He noted that past government expansions of health insurance didn't happen overnight.
When Congress 15 years ago created an insurance program for children whose families can't afford private coverage but make too much to qualify for Medicaid, nationwide enrollment quintupled from fewer than 1 million initially to 3.3 million two years later. It now covers more than 8 million kids.