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HealthCare Checkup

The Seattle Times health-care team tracks the local impact of the Affordable Care Act.

December 11, 2014 at 6:50 PM

State is one-quarter of way toward Obamacare enrollment goals

Close to 56,000 people have bought health insurance or renewed their coverage through the state’s online exchange, Washington Healthplanfinder. The state is slightly more than one-quarter of the way toward its goal of enrolling 215,000 people by mid-February.

“I’m cautiously optimistic about where we are,” said Michael Marchand, spokesman for the exchange.

In this second round of insurance enrollments under the Affordable Care Act, roughly 10,000 of the people signing up are new customers to the exchange. The state hopes to bring that number up to 85,000 by the close of open enrollment on Feb. 15. The other 46,000 are renewing customers.

Washington residents who want to make sure they have coverage on Jan. 1 must either sign up or renew their plan, plus make their first monthly premium payment, by Dec. 23.

“People are still shopping but that deadline is fast approaching,” Marchand said.

The enrollments, which started mid-November, have hit a few snags. Last week officials with the Washington Health Benefit Exchange, the agency operating the online insurance marketplace, announced that their computer system accidentally canceled the payments of about 6,000 customers buying plans for next year.

Richard Onizuka, the exchange’s chief executive officer, explained that the exchange’s system integrator, Deloitte, had run an “automated enrollment cancellation process in error.”

More than 4,000 of those customers are re-enrolled in the exchange, officials said Thursday. Exchange staff are continuing their efforts to contact the customers who haven’t reapplied and paid, Marchand said.

And in the first few hours of the second enrollment period, which started Nov. 15, staff realized that the site was miscalculating the amount of tax credits that people were eligible for. They took the site down, made the fix and relaunched the website by the next morning.

The exchange is still working to resolve problems from the last enrollment period in which people have made premium payments to the exchange or directly to insurance carriers, but that information is not being correctly shared between parties. That has left some people struggling to prove that they have insurance coverage or renew their coverage for 2015 because it appears they have outstanding balances. Marchand on Thursday could not say how many customers were still dealing with payment issues, but said they are working to resolve them.

In this second enrollment period, exchange staff are more quickly identifying and fixing glitches in the system, Marchand said. They’re working to respond directly to specific customers who are having problems, he said.

“This is what you see as an organization and a system start to mature,” Marchand said. “We’re getting more into a rhythm.”

Despite improvements, state lawmakers, members of the board overseeing the exchange and the state Insurance Commissioner, Mike Kreidler, have in recent weeks expressed ongoing frustration with the technical problems. They have called for more transparency in the system, and there are discussions about changing some of the exchange’s operations, including stripping it of its ability to collect premium payments.

It’s important for the exchange to meet its sign-up goals during open enrollment. The marketplace is legally required to be self sustaining beginning next year, with funding primarily coming from fees charged to insurance companies and taxes levied against the plans that it sells (all insurance plans are taxed, but the taxes collected on plans sold through the exchange go back to Washington Healthplanfinder).

While the state is about 26 percent toward its enrollment goal, exchange officials expect a surge in signups right before the Dec. 23 deadline for coverage starting Jan. 1, and right before the last day of enrollment in February.

During last year’s longer enrollment window, which began in October and ended in March, some 40 percent of the customers bought their plans by the December deadline.

For the first time this year, the exchange also is offering insurance statewide to small businesses with 50 or fewer employees through Washington Healthplanfinder Business. So far three employers have bought coverage through the small-business exchange, and an additional 73 businesses are partway through the enrollment process. There is no open-enrollment period for the small business exchange, so companies can sign up throughout the year.

There are potential tax benefits for individuals and businesses buying insurance through the exchanges. Individuals with low-enough incomes can qualify for tax credits that reduce the price of their monthly premium. If low-income residents buy a mid-level or “silver” insurance plan, they may be eligible for additional benefits that reduce their out-of-pocket expenses for health care. Certain businesses can also qualify for tax benefits, but they are not calculated and provided at the time businesses buy their coverage.

Individuals and businesses can also buy insurance outside of the exchange, but those policies are not eligible for tax breaks.

Most Americans are required to have health insurance or risk a penalty. For 2015, that penalty is $325 per adult and $162.50 per child or 2 percent of their adjusted household income — whichever is larger.

Comments | Topics: Affordable Care Act, health insurance, Washington Health Benefit Exchange

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