Roll Call: Latest News on Capitol Hill, Congress, Politics and Elections
September 3, 2014

Why Obamacare Enrollment Numbers Are Higher Than Forecast

Sophie Novack: “As the final figures before the end of open enrollment are posted, a significant chunk of people who bought insurance under the law will be missing from the official tally.”

“Off-exchange enrollment is the forgotten piece of the Affordable Care Act, but it could represent millions of people who are also getting covered as a result of the health care law.”

“People who enroll outside of the exchanges are simply using a different means to buy what are often the same ACA-compliant plans available inside the exchanges. They are part of the same risk pools and have the same impact on premiums.”

L.A. Times: “As the law’s initial enrollment period closes, at least 9.5 million previously uninsured people have gained coverage. Some have done so through marketplaces created by the law, some through other private insurance and others through Medicaid, which has expanded under the law in about half the states.”

“The tally draws from a review of state and federal enrollment reports, surveys and interviews with insurance executives and government officials nationwide.”

“About 9 million people have bought health plans directly from insurers, instead of using the marketplaces, Rand found.”

  • http://medicareblog.org Denise_Early

    People who go directly to insurance companies do not get a subsidy, so many of those are probably people who had health insurance that was cancelled, or they saw a better deal in newly designed plans.

    As an insurance broker in Arizona I have had clients who were enrolled in individual plans that almost all had a $5,000 deductible and 3 doctor visits per year for a co-pay. Those clients, even without a subsidy, can get a Gold or Platinum plan for nearly the same price – and much better coverage.

    I have a client who is in her late-50s and married to a retired doctor. Her 65+ year old husband has Medicare and she has had an okay-but-not-great $5,000 deductible plan. I asked her if she wanted to spend $50 more per month for a Platinum PPO plan with a nationwide network and all her doctors. She jumped at the chance to have an awesome plan that is very much like an employer plan. She’s paying $450 per month.

    My sister in Connecticut will not deal with “OCare”, as she calls it. And premiums in CT are twice as much as in Arizona. But she can get a Bronze plan with unlimited doctor visits (and everything else coming under the deductible) for $500 per month. Since she is just 18 months from Medicare, this is not a bad plan for a healthy person. And if she should get sick, her total risk is the $6,350 max-out-of-pocket limit on the Bronze plan. She could not believe she could get a decent plan for $550 per month in CT. I told her to move to Arizoa and get a Platinum plan with $0 deductible for the same price as a Bronze plan in CT.

    Arizona has a competitive market and some very reasonable premiums, even for people who do not get a subsidy. I have enrolled about half of my clients directly through insurance companies because their income was too high for a subsidy. People who qualify for a subsidy must be willing and able to go online at healthcare.gov and provide income and identity info. This is not easy for people with no computer skills and limited education. This is where navigators and application assisters come in.

    Since so many people are procrastinators, I think the government should just say there is one more month to sign up, on or off the exchange. Who can argue that allowing people to get health insurance is a bad thing? Only nasty, mean-spirited Republican politicians who have excellent coverage thanks to taxpayers. Part D enrollment was extended for six months, so why not something much more important?

    • Lorehead

      Thanks for sharing those stories. I signed up for an ACA-compliant plan off the exchange, replacing my old one, because it was a lot simpler than going through Cover Oregon and I wasn’t eligible for subsidies anyway.

  • JoeDrager

    Whyare the numbers higher? Simple – they lie about the numbers. Next question?

    • http://medicareblog.org Denise_Early

      The final number won’t lie. And even if there are millions of people who had insurance but switched to a new plan, isn’t it a good thing if they got better insurance?

      I just got a call from someone whose Gold Rule plan is ending in May. He can continue his current plan with a $200 premium increase. His plan will cost $700 per month for a $2500 deductible plan with a $10,000 MOOP.

      I looked up Health Net plans for him and he can get a Gold PPO plan (nationwide network) for $539 per month. $500 deductible! $4,000 MOOP. He gets no subsidy. The new health insurance market in Tucson is a great thing for this man. Why is that a bad thing?

      But now the question: Is he allowed to change his plan since the open rnrollment “deadline” has passed? His plan is technically ending at the end of April, but this is not on the list of “life events” that shows on the home page of healthcare.gov. I’ve asked Health Net if he gets a special enrollment period because his plan is technically ending. He is allowed to renew under the new rules, but can he drop the plan and get a new one?

  • teridavisnewman

    The numbers are higher because Obama is lying. If Obama’s lips are moving, he’s lying.

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