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Reform Update: Enrollment efforts surge as March 31 deadline looms


By Paul Demko
Posted: March 13, 2014 - 3:30 pm ET
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With just over two weeks left in Obamacare's 2014 open enrollment period, insurers, hospitals, insurance exchanges, community health centers and not-for-profit groups across the country are racing to sign up millions of uninsured Americans. At stake is the public perception heading into the November elections of whether the Patient Protection and Affordable Care Act is working—though many experts say the total enrollment this year will not be the ultimate determinant of the law's success.

Insurers overall have been spending about $10 million a week on advertising since the beginning of December, when the federal HealthCare.gov website started working more effectively, said Elizabeth Wilner, senior vice president for Kantar Media Intelligence. While that spending has remained relatively stable, as the signup deadline nears more insurers are explicitly referring in their ads to the healthcare reform law and its open enrollment period, instead of just promoting their brand.

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“Those large insurers who shied away from it earlier are now realizing that urging people to sign up by the deadline is probably a pretty helpful message to have in the ads,” Wilner said.

The heavy insurance industry advertising is likely to help the wide range of other, less-wealthy organizations that are working intensively on signing people up over the next two weeks. Those efforts are seen as particularly important in states where elected officials have opposed the ACA and have not enlisted government resources to boost enrollment.

Cover Missouri, a coalition of 400 organizations, plans to hold more than 140 events promoting the ACA in the final month of the enrollment period. On March 8, for example, the St. Louis Effort for AIDS hosted “Rock Enroll,” which featured live music, tacos and five counselors to help attendees sign up for health plans.

On Saturday, Kentucky's state-run insurance exchange plans to take part in signup events in 117 of the state's 120 counties. There will be live radio broadcasts from nine of the events, including those in Paducah, Owensboro and Bowling Green.

Independence Blue Cross in Pennsylvania is sponsoring a contest in which Philadelphia-area college students create videos explaining why it's important to get health insurance coverage. Voting for the grand prize winner, which comes with a $10,000 award, continues through March 24.

Daniel Hilferty, president and CEO of Independence Blue Cross, said his company's efforts in the final weeks, including the video contest, are aimed at attracting the so-called young invincibles who are seen as critical to creating a balanced risk pool. Already, the share of 18- to 34-year-old exchange customers in Pennsylvania has increased from 27% during the first four months of operations to 30% in February and March.

“Although they're late, they're starting to roll in,” Hilferty said.

Supporters of the Affordable Care Act hope these final outreach efforts—particularly those aimed at younger individuals—can salvage what started as a rocky open enrollment period last October. This week the CMS announced that 4.2 million individuals had enrolled in private health plans through the state and federal exchanges as of the end of February. That means there would need to be 1.8 million additional enrollments in March to meet the Congressional Budget Office's projection of 6 million.

On Wednesday, Avalere Health estimated that 5.4 million signups by March 31 is more likely. That figure was arrived at by assuming that ACA enrollments would proceed at the same pace as Medicare Part D prescription-drug-plan enrollments did during that program's initial sign-up period in 2006. In that program, 22% of enrollments occurred during the final month.

A demographic group where Obamacare enrollment has lagged is among Latinos. In California, for instance, more than half of the state's uninsured are thought to be Latinos. But through January, they represented just 21% of enrollments through the state's exchange.

Last week, Covered California launched a marketing campaign featuring legendary activist Dolores Huerta, who worked closely with the late Cesar Chavez in organizing farmworkers. Huerta is appearing in radio and YouTube spots urging people to sign up for coverage by March 31—which also happens to be Chavez's birthday. “We are using that to pound the drum to promote enrollment in the Latino community,” said Peter Lee, executive director of Covered California.

Acceptance of Obamacare growing, according to Bloomberg poll

Nearly two-thirds of Americans don't want the ACA repealed, according to a Bloomberg National Poll released on Wednesday. That includes 51% who want to retain the law with “small modifications” and 13% who would keep it intact. Roughly a third of respondents indicated that they want the law repealed. Still, President Barack Obama's handling of healthcare issues remains unpopular, with 54% of Bloomberg respondents expressing disapproval.

Up to 20% haven't paid premiums yet

The 4.2 million ACA enrollments reported by the Obama administration come with a significant caveat: It includes individuals who haven't made their first premium payment and therefore aren't actually covered. Administration officials insist that they can't yet provide any reliable data about what percentage of enrollees haven't paid their bill. But Politico reports, based on a survey of officials at four big national insurers, that 15% to 20% of individuals who signed up for coverage through the state and federal exchanges haven't yet paid. If that proves accurate, it means the actual number of individuals who are now enrolled in private plans is likely closer to 3.5 million. The insurance officials say the administration has these numbers but doesn't want to publicize them while it's trying to present the enrollment story as a success, the Politico article said.

Follow Paul Demko on Twitter: @MHpdemko


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