Indiana among WellPoint’s weakest exchange states

WellPoint Inc. CEO Joe Swedish declared last week he was “very cautiously optimistic” about the Obamacare exchanges.

“Rather than saying I'm optimistic, I think the better term is cautiously optimistic. Very cautiously optimistic,” Swedish told the Washington Post.

To understand that equivocal statement, it’s helpful to look at data from the 14 states in which Indianapolis-based WellPoint is selling insurance policies on the new Obamacare exchanges.

In short, they’re all over the map. And Indiana residents have shown nearly the least interest—when measured against the number of uninsured in each state and by the age of enrollees.

At the end of the year, 79,195 Hoosiers had proceeded far enough through the sign-up process on the website to be ready to select a plan. That number represented only 8.7 percent of uninsured Hoosiers, according to data from the Transamerica Center for Health Studies. That’s the lowest level of interest among all of WellPoint’s 14 states.

The best performer was Kentucky, which is running its own exchange. Enough consumers there got to the point of selecting a plan that it equaled about 25.5 percent of the state's uninsured.

When those who came to and were deemed eligible for Medicaid are added to the exchange enrollees, Indiana looks slightly better—but not much. Consumers equal in number to 13.4 percent of the state's uninsured went that far on the site–third-worst among WellPoint’s states behind Ohio and Georgia.

Kentucky, again, was best, with consumers equaling 41.7 percent of that state's uninsured deemed eligible for Medicaid or at least ready to enroll in a plan.

At year end, 30,443 Hoosiers, equal to just 3.45 percent of Indiana's uninsured, had actually selected an exchange plan. That was second-lowest among WellPoint’s states, behind Ohio.

Indiana’s enrollment places it 24 percent toward the enrollment the Obama administration and the Congressional Budget Office expected for the state. That is equal to the average among all 36 states participating in the federal exchange.

But the age mix in Indiana is not good: 73 percent of exchange enrollees are 35 to 64, compared with an Obama administration goal of 60 percent. Only 21 percent of enrollees are ages 18 to 34, compared with an Obama administration goal of 40 percent.

An analysis by University of Houston law professor Seth Chandler found that Indiana’s mix of low enrollment and poor age mix rank it 10th worst on what he calls a Maelstrom Index.

“Just because the ACA is doing better than some had forecast on an overall basis does not mean there will not be very serious problems in some states,” Chandler wrote in a Jan. 13 blog post.

At least one analyst expects WellPoint to lose about $85 million on the Obamacare exchanges next year.

But WellPoint officials say their benchmark isn’t the Obama administration’s goals, but their own expectations. Swedish suggested that WellPoint priced its products this year under the assumption that the age mix would be worse than the White House predicted.

“We also priced for higher levels of acuity in the exchange products, relative to our traditional individual business,” he told investors in San Francisco last week. “Despite the near-term uncertainty, we believe exchanges will be growing as a big part of the market over time. We are more focused on the end game of exchanges than the twists and turns in the near term.”

According to data from the U.S. Department of Health and Human Services, more than 909,000 uninsured Hoosiers would be eligible for coverage through the Obamacare exchange or an expanded Medicaid program. Indiana has decided not to expand eligibility of its Medicaid program, as called for by Obamacare.

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