The number of uninsured non-elderly adults has dropped by more than 10 million since the launch of state and federal exchanges last year, according to the latest data from the Urban Institute's Health Reform Monitoring Survey.
The uninsured rate nationwide was 12.4% in September, down roughly 30% from 17.5% a year earlier. The quarterly survey has recorded a steady reduction in the rate of uninsured over the last year. The Urban Institute's data tracks other reports that have shown a significant decrease in the uninsured rate since the full implementation of Obamacare.
The changes have been significant both in states that have expanded Medicaid eligibility to households with incomes up to 138% of the federal poverty threshold, as allowed under the Patient Protection and Affordable Care Act, and those that have chosen not to move forward with expansion. In non-expansion states, the uninsured rate has dropped from 20.1% to 15.1% over the last year. In states that have adopted Medicaid expansion, the uninsured rate dropped from 15% to 10.2% since the exchanges were launched.
Enrollment through the state and federal exchanges is largely limited to open-enrollment periods. But individuals who have a qualifying life event, such as getting married or having a child, can sign up for coverage outside the enrollment window. In addition, low-income households can sign up for Medicaid at any time throughout the year.
The second-open enrollment period under Obamacare started last month and runs through Feb. 15. The CMS announced on Wednesday that more than 750,000 individuals signed up for private plans through HealthCare.gov during the two weeks. Those applicants were split almost evenly between those seeking coverage for the first time and customers renewing plans that they signed up for during the first open-enrollment period. No enrollment statistics have been released for the 13 states, including California and New York, that are running their own exchanges.
State officials in Florida, Illinois, Michigan and Missouri reported a similar mix of new applicants and returning customers during a call with reporters Wednesday organized by Families USA, which supports the federal healthcare law.
Jennifer Koehler, executive director of Get Covered Illinois, said the group is working more closely with brokers in the second open-enrollment period. Roughly a dozen insurance brokers have signed up for Get Covered Illinois's ambassador program, Koehler said, which entitles them to matching funds to help pay for advertising.
Koehler's group also is targeting potential customers in rural pockets of the state with direct mail pieces promoting enrollment opportunities. They'll be monitoring call-center activity and Web traffic to see how effective that marketing effort is in reaching rural residents.
Ryan Barker, vice president for health policy at the Missouri Foundation for Health, which is spearheading a statewide outreach effort, said his group is focusing less on large events than it did during the first year and more on one-on-one engagements.
“Most of our assisters are booked solid,” Barker said. “So far, we have not heard of a lot of confusion.”
State officials also report that they're seeing an increase in the share of exchange customers who are scrutinizing provider networks and drug formularies when picking a plan. In the first open-enrollment period, experts say, many enrollees opted for plans with low monthly premiums and ignored other important coverage features.
“Our consumers have become more sophisticated,” Barker said. “What's best for your family is more than just the dollars and cents.”
The CMS has estimated that 9.1 million individuals will be enrolled in exchange plans in 2015. The Congressional Budget Office has projected 13 million enrollments next year.
The Urban Institute's online survey includes responses from roughly 7,500 non-elderly adults. It has a margin of error of plus or minus 1.3 percentage points.
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