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HealthCare Checkup

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

January 8, 2015 at 6:46 PM

With 107,000 enrollees, Washington is halfway to insurance sign-up goal

Washington is halfway to its goal for insurance signups through the state’s Washington Healthplanfinder exchange, according to numbers released Thursday.

But with more than 107,000 people buying health insurance from Healthplanfinder through the end of December, the exchange still hasn’t caught up to the number of people enrolled before the signups for the current enrollment period began in mid-November.

That raises the pressure to reach the state’s target of 215,000 customers in the six weeks left until the Feb. 15 close of enrollment for this year.

It’s “an aggressive target,” said Bethany Frey, spokeswoman for Washington Health Benefit Exchange, which runs the online insurance marketplace.

So far only 80,000 of the 140,000 former customers that enrolled in the first enrollment have renewed their plans through the state, according to officials. Their goal is for 130,000 of their past customers to renew their coverage, plus they hope to sign up 85,000 new enrollees. People needed to renew or sign up by late December to ensure there would be no gap in their coverage beginning Jan. 1.

“We would like that [renewal] number to be higher, to be as close to 100 percent as possible,” Frey said. “It’s hard to know why they’re not coming back, but every customer has gotten letters or emails” reminding them to re-enroll.

Most of the customers who haven’t returned have unpaid balances on their insurance for 2014, Frey said. But legally people can still sign up for a plan for next year, even if they still owe on past coverage.

Insurance enrollment numbers are more favorable elsewhere in the country during this second round of signups under the Affordable Care Act.

Roughly 7.1 million Americans signed up for health insurance or were automatically renewed for coverage by late December, according to the U.S. Department of Health and Human Services. That’s an increase of  approximately 400,000 people compared with how many were enrolled before the new sign-up period started. The renewal process through the federal exchange was more passive for customers, Frey said, which could result in higher numbers for states using that exchange. 

Washington was one of 16 states that ran its own exchange last year and, despite some significant technical troubles, folks around the country lauded it as one of the most successful insurance marketplaces.

But some technical problems have persisted into this second round of enrollments, snarling applications and frustrating customers. When the exchange opened in November, the site was quickly taken offline and fixed when officials discovered it was calculating tax credits incorrectly. In December, the exchange announced that Deloitte, its tech contractor, accidentally canceled payments made by 6,000 customers. About 90 percent of those accounts have been reinstated.

The exchange “is better than it was last year but there are still problems,” said John Anderson, an insurance broker in Kent. Anderson this week was trying to help a client who is out of work and struggling with his exchange enrollment. The client’s application stalled when it asked for verification of his employment.

“He’s on unemployment,” Anderson said. “What’s he supposed to do?”

People needing to buy their own insurance have the choice of purchasing it through the exchange or shopping outside of Healthplanfinder through brokers or from insurance companies. But there’s an incentive to use the exchange; only those who purchase exchange plans are eligible for tax benefits that can reduce monthly premiums and reduce the cost of medical bills for those with incomes low enough to qualify.

Washington residents who had technical problems with their applications and missed the deadline for Jan. 1 coverage can file an online petition for retroactive coverage to the beginning of the year. Exchange officials will grant coverage to people who received an incorrect tax credit calculation, if their plan was incorrectly canceled or if their application had a system error. So far about 1,500 people have applied for the extension.

Some experts and pundits predict that the Obama administration will reach its overall target of 9.1 million exchange enrollments, but it’s hard to say if Washington will make the mark.

“We’re hopeful the [Washington] exchange will meet their enrollment targets and know they’re making every effort to do so,” said Stephanie Marquis, a spokeswoman with the state Office of the Insurance Commissioner. Commissioner Mike Kreidler has been critical in recent months of exchange operations.  

Sammamish broker Lori Comer said her exchange clients were for the most part sticking with it. “I am not seeing a trend towards not renewing,” Comer said.

Looking back at the enrollments during the first sign-up period, by the end of December 2013, some 67,000 people had purchased insurance through Washington’s exchange. But by the close of enrollment in March, more than 164,000 people were enrolled. The enrollment period is shorter this time, but Frey said they still expect to see a surge before the end.

While the overarching goal of the Affordable Care Act is to insure nearly all Americans, the state’s enrollment goals are important. That’s because the state’s online marketplace is legally required to be financially self-sustaining beginning this year. The exchange’s funding comes primarily from fees charged to insurance companies and taxes levied against the plans sold through the exchange, as well as from the state agency that manages Medicaid.

In addition to selling insurance to individuals, the state exchange also has plans for small businesses with 50 or fewer employees. This is the first time Washington Healthplanfinder Business has been available to employers statewide, but so far only nine businesses have fully enrolled and an additional 39 have completed applications.

There are a number of reasons why businesses could be slow to sign up. Only Moda Health is offering exchange plans statewide, which significantly limits the choices. Brokers also say there are more affordable options outside of the exchange.

As with the individual insurance exchange, the business plan exchange offers tax benefits, but they’re limited to employers with fewer than 25 employees making an average of $50,000 a year. Additionally, some employers are scared off by the exchange’s technical glitches.

But there’s no enrollment period for the business exchange and employers can sign up year round, so participation could continue to grow beyond February.

The exchange is also the website for people to enroll in or renew their health coverage through Medicaid. Since the exchange first launched in October 2013, more than 471,000 new adults have used the exchange to access Medicaid, locally called Washington Apple Health.

People who do not have insurance through an employer or government program such as Medicare or Medicaid need to buy individual insurance or risk a penalty for being uninsured. This year that penalty is $325 per adult and $162.50 per child or 2 percent of adjusted household income — whichever is larger. So a single person earning $40,000 would be hit with the 2 percent penalty, which, after their income is adjusted, comes to $597.

Comments | Topics: Affordable Care Act, health insurance, Medicaid

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