Time to eat crow and fix my error on Obamacare sign-ups

May 5, 2014
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OK, it’s time to man up and say it: I was wrong.

I, like most everyone else, did not expect the rush of enrollment on the Obamacare exchanges in March.

So when I predicted on March 13 that Obamacare would fail to expand individual private insurance coverage in Indiana, I was completely off.

It turned out that 132,423 Hoosiers selected a health insurance plan on the Obamacare exchange by the end of March, and more have since.

That enrollment figure, released on Thursday, marks a 104-percent jump from the enrollments recorded from Oct. 1, when the exchange opened for business, until the end of February, when just 64,972 Hoosiers had signed up.

Now, it’s important to remember that not all who have selected a plan have paid for it. Officials from Anthem Blue Cross and Blue Shield informed me last month that about 15 percent of their exchange-plan enrollees had not paid their premiums for the first month.

If that rate of payment holds true for the three other insurance carriers selling on the Obamacare exchange in Indiana, it would mean that 112,560 Hoosiers actually obtained coverage in the exchange.

That’s almost exactly the number of Hoosiers who were previously buying individual health insurance and who had household incomes that would qualify them for a tax subsidy to buy coverage in the Obamacare exchange.

The move of those Hoosiers into the exchange explains much of the Obamacare story in 2014. Of those selecting a health plan, 89 percent qualified for a tax subsidy, according to statistics released last week by the U.S. Department of health and Human Services.

Wow. Nine out of 10. That’s a higher percentage than just about anybody predicted.

It does appear that a lot of Hoosiers may have obtained individual health insurance through other means. Or, in some cases, decided to go without.

The Associated Press noted that 40 percent of Hoosiers who could have signed up for an Obamacare plan—or nearly 100,000 people—failed to do so before the March 31 deadline.

That could be because young Hoosiers chose to go without insurance. Among Hoosier enrollees in the Obamacare exchange, 33 percent were younger than 35—compared with a goal for exchanges of 40 percent.

The tax for not having coverage is modest this first year—$95 per adult in a household or 1 percent of household income. And surveys show a fair number of young people don’t even know they will be taxed for going uninsured.

Another place Hoosiers are getting health coverage is in the "off-exchange" market. That's where Obamacare-compliant plans are sold via brokers, not via the HealthCare.gov web site used for the exchange.

WellPoint Inc., the Indianapolis-based parent of Anthem, reported in January that its nationwide enrollment in the “off-exchange” insurance market equaled roughly 20 percent of its enrollment on the exchange. If that number held true for Indiana through the end of March, it would mean 22,500 Hoosiers obtained coverage in the off-exchange market.

On top of that, health insurers offered most of their 2013 individual insurance customers the option to renew their pre-Obamacare plans before Dec. 31, thus allowing those customers to remain covered without buying an Obamacare-compliant plan.

Statewide about 108,000 people fell into that situation, according to an estimate from the Indiana Department of Insurance. Anthem said about 70 percent of the customers to which it offered this "early renewal" accpeted that option, which was far higher than the 30 percent Anthem expected.

If that 70-percent figure held true across the market, it means another 75,000 Hoosiers obtained coverage that way.

If my rough estimates are correct, it would mean an additional 97,500 people obtained coverage outside the Obamacare exchange, in addition to the 112,500 who bought coverage on the exchange. That’s a total of 210,000 Hoosiers obtaining individual insurance coverage.

Compared with the 2013 individual insurance market in Indiana, which included 178,000 Hoosisers, that’s an 18-percent increase in the number of people covered.

What we still don’t know is how many of those newly covered people were previously covered by an employer that decided to end its group health plan. Insurance brokers told me last fall that they were ending numerous employer health plans, but none of those employers wanted to talk to me.

But I still must correct myself and say that Obamacare has indeed expanded private individual health insurance in Indiana.

It’s nowhere near the universal coverage promised when President Obama first proposed his health care reform. And it’s still a long way away from the projections put out when the law was passed in 2010.

But it is a start. And it is a victory the president and the supporters of Obamacare can certainly celebrate.

  • Only the Start
    This is just the start of people getting coverage through the marketplace. Tax credits and cost sharing reductions have huge impacts on decision making.
    • Agree w/Tony
      Yes, once people see the tax credits and cost sharing reductions available, many are pleasantly surprised what is available on the Marketplace. Sometimes, even the higher premium Marketplace plans can be a worthwhile investment for those who use a lot of health care services, as the copays and deductibles are often lower than the "zero premium" (after tax credit) plans. I am hoping we will get at least one more carrier in Indiana for the 2014 Open Enrollment. Humana is selling off-Marketplace only for 2013-2014, so maybe they will join the Marketplace for 2014-2015?
      • Silver
        The cost-sharing Silver plan was one of the most popular options our customers enrolled in. If you qualify for a larger subsidy, only on Silver plans can you see "cost sharing" which potentially reduces deductible and out-of-pocket expenses. It's a feature brokers are well aware of, but sometimes not consumers.
      • Additional Carriers on the Exchange
        I believe on May 10th is the deadline for the health insurance companies to file with IDOI to sell on the exchange. I am expecting at least one more carrier and maybe two to file to sell on the marketplace.
      • bills not out
        I have a friend who signed with Anthem and is still waiting for the first bill. This may explain why only 85% have paid. She is eager to pay this bill.
      • Ouch
        I had one of those private plans for a family of four, $10,000.00 deductible / $950 a month. I was told by my insurance company that Indiana required them to offer the bronze level exchange policy to anyone who expired in 2014. I evidently do not qualify for subsidies (but I must be at the bottom rung of that ladder). The Affordable healthcare bronze package was over $1900. a month and $12,000 deductible. So it seems to me that the family that can afford healthcare cover, basically pays for another family that cannot afford coverage. What a deal.
      • increase or decrease?
        The number of people signing up should increase because employers are dropping their coverage and forcing employees to get their own coverage, especially small to medium size companies. This is not the solution that we were sold at the beginning. It is a nightmare that will increase government size and scope.

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