Enrollment in exchange coverage increased from 6.3 million at the end of 2014 to about 8.8 million, according to figures released by the administration at the end of last week.
But Obamacare’s coverage gains have also been more modest than expected, particularly when it comes to the exchanges. And part of the problem seems to be that people who sign up for coverage at the beginning of the year don’t always follow through to keep their coverage effective at the end of the year. It’s a problem that seems to be larger than the administration knew.
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Along with releasing end-of-the-year 2015 enrollment data for the Affordable Care Act exchanges last Friday afternoon, the Department of Health and Human Services also released data for the 2016 open enrollment period. Just like the end-of-the year 2015 enrollment data, which I discussed on Monday, a close look at the 2016 open enrollment data reveals that the ACA is significantly underperforming initial expectations.
The big story is how little has changed from 2015 to 2016. The number of 2016 exchange enrollees is up only slightly from last year, and the make-up of the risk pool—as proxied by income and age of enrollees—is virtually identical.
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Vermont has filed a 1332 state innovation waiver to avoid building a website for its small-business insurance exchange. The state hopes to have those employers enroll directly through insurers.
Under the waiver, beginning Jan. 1, 2017, states can request that the federal government waive basically every major coverage component of the Affordable Care Act, including exchanges, benefit packages, and the individual and employer mandates. The only requirement is that a state’s healthcare coverage remains consistent and adequate. Vermont is the first state to send a finalized request (PDF) to the CMS.
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The Affordable Care Act’s health insurance co-ops absorbed deep financial losses last year, and 2016 is shaping up to be a make-or-break year for these nonprofit alternatives to traditional insurers.
Officially called Consumer Operated and Oriented Plans, these still-fledgling insurers were devised during the ACA’s creation to inject competition into insurance markets. But they have struggled from the start to build a customer base from scratch and deal with higher-than-expected expenses, among other problems.
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Last year’s final enrollment numbers under President Barack Obama’s health care law fell just short of a target the administration had set, the government reported Friday.
The numbers are important because the insurance markets created by the president’s 2010 health care law face challenges building and maintaining enrollment. The marketplaces offer subsidized private insurance to people who don’t have access to job-based coverage.
The report from the Health and Human Services Department said about 8.8 million consumers were still signed up and paying premiums at the end of last year.
HHS Secretary Sylvia M. Burwell had set a goal of having 9.1 million customers by then.
The average monthly ObamaCare premium grew by about 5 percent over last year once financial assistance is factored in, according to government data released Friday.
The average monthly premium on the ObamaCare marketplace is $106 this year, compared to $101 last year, according to a new Department of Health and Human Services (HHS) report.
Those figures factor in the financial assistance under the healthcare law that substantially lowers the premiums consumers have to pay. Eighty-five percent of enrollees qualified for financial assistance.
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When agencies release information on a Friday afternoon, it is generally because of unfavorable news they hope will lose potency over the weekend. On Friday, the Department of Health and Human Services (HHS) released 2015 end-of-the-year exchange enrollment data. After reviewing the numbers, it is understandable why HHS would want this release to attract as little attention as possible.
Most news stories reporting the numbers have focused on the large overall decline in exchange enrollment throughout 2015—down 25% from the number of people who selected a plan at the end of open enrollment—or how the end-of-the-year number failed to meet even HHS’ downgraded target. The most striking number from the data, however, is the large drop in exchange enrollment—equal to about 1.13 million people—during the last six months of the year. As I explain below, this large net decline is problematic for the future of the Affordable Care Act (ACA) as it likely exacerbates other adverse selection problems induced by the law.
The failures of a dozen nonprofit health insurance plans created by the Affordable Care Act could cost the government up to $1.2 billion, according to a harsh new congressional report that concludes federal officials ignored early warnings about the plans’ fragility and moved in too late as problems arose.
The report, released Thursday by a Senate investigations panel, says that the bulk of those loans are unlikely to be recovered, with some plans unable to pay “a substantial amount of money” they still owe doctors and hospitals for members’ care.
In its release of wonk beach reading late last month, the 539-page HHS Notice of Benefit and Payment Parameters for 2017 and the 87-page 2017 Letter to Issuers in the Federally-facilitated Marketplace, the federal government displayed its latest efforts to apply science to the issue of network adequacy. Beginning in 2018, for policies sold on healthcare.gov, the federal government will rate and display plans as “Basic,” “Standard” or “Broad.”
This network rating will be in addition to the federal government’s current efforts to ensure that networks established by an insurer are not so sparse as to be useless to the consumer. It does not appear as if states running their own exchanges will be required to do more than assess insurer networks for adequacy; state websites will not have to grade the quality of insurer networks for policies sold on their exchanges.
A Senate panel found that the government ignored warning signs that Obamacare co-op plans were a bad bet when it doled out $1.2 billion in taxpayer funds to them.
The report from the Senate Permanent Subcommittee on Investigations, released during a hearing Thursday, found that in 2014 the Department of Health and Human Services gave out loans to failed consumer-oriented and operated plans, called co-ops, despite clear warning signs they weren’t reliable.
The co-ops were created to spur more competition on the Obamacare exchanges. However, of the 23 taxpayer-funded co-ops, 12 have shut down.
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