Cuts to ACA Haven’t Deterred Consumers
From Humana to Highmark, Health Insurers Leave Insurance Marketplace, but Consumers are Undeterred
Recently, federal funds that assist Americans signing up for health insurance coverage under the Affordable Care Act (ACA) were cut by 40 percent and the ACA advertising budget was slashed from $100 million to $10 million.
These moves demonstrate the determination of the current administration and many in Congress to minimize the ACA insurance market and overturn the healthcare law. While these efforts appeared to stall initial sign-ups, they did not deter people. The fifth annual season for Americans to buy insurance under the ACA opened on Wednesday, November 1, 2017 with reports of crowds, technical difficulties and a public confused as never before by the political turmoil surrounding the law.
The funding decrease is problematic for the 2018 enrollment period, which just got started and will only last six weeks this fall instead of three months as in previous years. Sign-ups are taking place with many consumers confused by the political fighting in Washington over whether the law and its marketplaces will continue to exist.
Open Enrollment Begins
The federal website HealthCare.gov says, “2018 Open Enrollment is here” and “Start a 2018 application now!” as both the federal and state insurance marketplaces attracted the year’s first customers. They came despite the 90 percent reduction in federal advertising about the sign-up window and the decision to send advance emails about enrollment to millions fewer Americansthan in past years.
The emails went only to people with current health plans through marketplaces created under the law, leaving out most of the names in a database of about 25 million consumers who once had such coverage or at some point explored the federal website.
Nonetheless, plenty of people in certain states appeared eager to register on November 1 at places still offering in-person assistance through the navigator program.
In the first few days of open enrollment, the number of participants swelled compared with past years, according to federal officials who spoke on the condition of anonymity because the administration has yet to release official numbers.
More than 200,000 Americans chose a plan on November 1, the day open enrollment began, according to one administration official. That’s more than double the number of consumers who signed up on the first day of enrollment last year. More than one million people visited HeathCare.gov, the official said, which amounts to roughly a 33 percent increase in traffic compared with 2016.
These figures capture only a portion of the nation’s overall ACA enrollment because they encompass states that either use the federal healthcare marketplace or rely on its website for their consumers to sign up for coverage. More than a dozen states and the District of Columbia run their own programs and do not use HealthCare.gov.
Many industry stakeholders were concerned that consumers wouldn’t sign up for coverage because Congress had tried to repeal it multiple times this year. But on opening day, many state exchange officials said that enrollment had exceeded their projections.
Connect for Health Colorado spokesman Luke Clarke said state officials had expected that 2,700 residents would log on to their exchange on November 1, but more than 4,000 did. “It’s way ahead of where we were last year, and a big surprise,” he said.
That same day in Connecticut, 1,596 residents enrolled in qualified health plans on the state exchange, while another 2,293 people either completed Medicaid applications or determined that they were eligible for the federal entitlement program. Access Health CT CEO Jim Wadleigh said in a statement that the state’s call center and website experienced a 15 percent increase in volume compared to opening day last year.
It’s all well and good that 2018 enrollment has been initially brisk, but what will the enrollment figures look like when the period ends on December 15, 2017, and how many insurers have made insurance plans available at a reasonable cost to consumers?
Healthcare Insurance Marketplaces
Many critics of the ACA say the law is “collapsing” and claim many insurers have left the ACA’s insurance exchanges or state-based online marketplaces where people can buy individual health insurance policies.
Today, it appears that about one-third of counties are projected to have just one insurer available for their insurance exchanges. That leaves 2.9 million consumers with little choice but to select the only insurer available in their county, which, ultimately, could put them in a financial bind due to high costs.
That statistic was echoed in a May 2017 editorial by former Health and Human Services Secretary Tom Price, in which he portrayed the ACA as a house on fire and “many of our fellow Americans are trapped inside.”
Some insurers already have decided to hike their 2018 premiums more than they would otherwise to position themselves for a possible adverse decision affecting the ACA. Consumer choice is limited due to insurers leaving the insurance marketplace. As of the November 1, 2017 open enrollment date, the following insurers have left the 2018 marketplace:
ATRIO Health Plans
Oregon - 6 counties
Aetna
Delaware - 3 counties
Iowa - 76 counties
Nebraska - 93 counties
Virginia - 51 counties
Anthem
California - 30 counties
Indiana - 92 counties
Kentucky - 61 counties
Maine - 16 counties
Missouri - 17 counties
Ohio - 87 counties
Virginia - 61 counties
Blue Cross Blue Shield Healthcare Plan of Georgia
Georgia - 73 counties
Blue Cross Blue Shield of Kansas City
Kansas - 2 counties
Missouri - 30 counties
BridgeSpan Health
Idaho - 44 counties
Oregon - 17 counties
Washington - 8 counties
Cigna Healthcare
Maryland - 24 counties
Community Health Plan of Washington
Washington - 14 counties
Health Tradition Health Plan
Wisconsin - 14 counties
Highmark
Pennsylvania - 7 counties
Highmark Health Insurance Company
Pennsylvania - 4 counties
Humana
Florida - 7 counties
Georgia - 9 counties
Illinois - 30 counties
Kentucky - 9 counties
Louisiana - 7 counties
Michigan - 9 counties
Missouri - 5 counties
Mississippi - 32 counties
Ohio - 7 counties
Tennessee - 30 counties
Texas - 10 counties
Innovation Health Insurance
Virginia - 19 counties
LifeWise Health Plan of WA
Washington - 4 counties
MDwise Marketplace
Indiana - 92 counties
Medica Health Plans
North Dakota - 49 counties
Minuteman Health, Inc.
New Hampshire - 10 counties
Massachusetts - 9 counties
Molina
Utah- 7 counties
Washington - 6 counties
Wisconsin - 30 counties
Northwell Health w/CareConnect
New York - 8 counties
Optima Health
Virginia - 17 counties
Premera Blue Cross
Washington - 1 county
Premier Health Plan
Ohio - 9 counties
Prominence Health
Nevada - 7 counties
Texas - 3 counties
Regence BlueShield
Washington - 2 counties
UnitedHealthcare
Virginia - 32 counties
Wellmark
Iowa - 4 counties
Final Thoughts
Clearly, the decisions by insurers to pull out of the insurance exchanges have been driven by the financial risk and an uncertain outlook for the marketplace. Insurers face continued uncertainty even in the midst of open enrollment. Some insurers explicitly have factored this uncertainty into their initial premium requests, while other companies say if they do not receive more clarity or if cost-sharing payments stop, they plan to either refile with higher premiums or withdraw from the market altogether.
What does this mean for consumers? They should expect a reduction of choices for insurers offering plans in their area and higher insurance rates due to the uncertainty of the marketplace.
Read the full article here: http://ow.ly/9BNa30gCF96
Thoughts? Please share below.