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Reform Update: Exchange enrollment surged to 2.1M as 2013 ended


By Jessica Zigmond
Posted: January 2, 2014 - 2:45 pm ET
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The final days of 2013 brought good news for the Obama administration and the state and federal insurance exchanges as the CMS announced a big enrollment surge in December. The agency reported that more than 2.1 million people have signed up for private health plans since Oct. 1 and that 3.9 million people have been found eligible for Medicaid and CHIP.

That falls somewhat short of the Obama administration's projection of 3.3 million enrollments in private plans by Dec. 31. But the totals are far better than the paltry numbers during the first two months of enrollment in October and November, when signups were hampered by severe information technology problems on the federal website and some of the state sites. On Dec. 1 the administration announced that that the federal HealthCare.gov enrollment website had been largely repaired.

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“Our HealthCare.gov enrollment nearly doubled in the days before the Jan. 1 coverage deadline compared to the first weeks of the month,” CMS Administrator Marilyn Tavenner wrote in a blog post on New Year's Eve. “Nationwide, including state and federal marketplaces, December enrollment so far is nearly six times that of October and November combined.”

But concerns linger about whether everyone who thinks they signed up for coverage effective Jan. 1 actually will have coverage if they go to a healthcare provider. Insurers say they are worried they haven't received full and accurate enrollment information from the insurance exchanges. In addition, there are worries that a disproportionate share of the new enrollees are people with pre-existing medical conditions rather than younger, healthier people. The administration did not release any data on the age composition of the new pool of enrollees.

The federal site saw its peak day on Dec. 23—the deadline for enrolling for coverage effective Jan. 1—when it had 83,000 concurrent users. On Christmas Eve, the site had a total of 880,000 visits without any “queuing,” a system designed to send consumers an e-mail message alerting them when they can return to the site at the start of the line and complete their applications. Call centers were also busy on Christmas Eve, when the centers received 317,000 calls.

Tavenner said 3.9 million Americans learned in October and November that they're eligible for coverage through Medicaid and the Children's Health Insurance Program, which includes both new eligibility determinations as well as Medicaid and CHIP renewals.

Despite the uptick in enrollment figures, the Republican side of the House Energy and Commerce Committee earlier this week posted a series of articles that warn consumers of what the Republicans say will be soaring healthcare costs in 2014 as a result of the Patient Protection and Affordable Care Act.

“The president promised American families would see their healthcare costs go down an average of $2,500—but sadly, that pledge is turning out to be another broken promise as folks are bracing for the law's rate shock and higher costs set to kick in starting Jan. 1, 2014,” the committee's Republican leadership posted on the committee's site. “Not exactly a Happy New Year.”

Open enrollment for private coverage in 2014 continues through March 31, after which people who haven't signed up may face a tax penalty for not having insurance.

Sebelius certifies exchanges are verifying eligibility

HHS Secretary Kathleen Sebelius has certified to Congress that the federal and state health insurance exchanges are verifying the eligibility of applicants for premium tax credits and cost-sharing subsidies for advance payments of the premium tax credit and cost-sharing reductions. Congress required Sebelius to send the report by year's end under the deal it reached in October to reopen the government.

Attorneys general oppose selling noncompliant plans

West Virginia Attorney General Patrick Morrisey has spearheaded a letter signed by 10 other Republican attorneys general (PDF) who oppose the Obama administration's November decision to allow insurance companies to continue offering plans that do not comply with the Affordable Care Act's mandates. “We support allowing citizens to keep their health insurance coverage, but the only way to fix this problem-ridden law is to enact changes lawfully: through congressional action,” the letter said. Attorneys general from Alabama, Georgia, Idaho, Kansas, Louisiana, Michigan, Nebraska, Oklahoma, Texas and Virginia also signed on.

Follow Jessica Zigmond on Twitter: @MHjzigmond


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