Amongst all the noise about the exchanges and enrollment, it is all-but-impossible to separate the BS from the RS (real scoop). So, here are a few factoids.
- Overall, enrollment for 2014 continues to lag behind initial projections,which the CBO estimated at 7 million last June, then lowered to 6 million this month.
- A recent analysis indicated some states’ active efforts to hinder enrollment are working, and are partly responsible for the shortfall in enrollment.
Ed note – In those states, blaming the Administration for low enrollment while doing your best to prevent it yourself is like blaming your mom for your bad grades after you refused to study. - As of Feb 1, 3.3 million have enrolled via the exchanges.
- 55% are female
- 27% are 18-34
- 31% ar 55-64
- 82% get some level of subsidy
- CMS may require health insurers selling via the federal exchanges to make sure at least 30 percent of “essential health providers” are in-network in 2015. This in response to some complaints about networks that are allegedly too narrow.
Ed note – Which is kind of ridiculous; smaller networks are better at controlling costs and that’s a BIG part of the success criteria for health reform. - California’s website was recently down for five days due to software problems. Bad timing as a marketing push had just been rolled out. Nonetheless, private insurers had enrolled about 829,000 members as of a week or so ago. About 86% of CA enrollees benefit from fedreal subsidies.
- Anthem added 223,640 members
- Blue Shield gained 213,6467
- Kaiser increased by 131,448
- The flood of new enrollees are causing some delays in issuing ID cards, with Anthem among those “challenged”.
- Anecdotally, many of the new enrollees appear to be new to insurance as well. This may indicate a substantial percentage of exchange enrollees were previously uninsured.
- “Private” exchanges saw a big volume increase in late 2013 and that appears to be continuing into this year.
What’s the net?
Too early to tell. Looks like things are going much better than late last year – but things were such a horror show that may be “damning with faint praise.”
We will have a much clearer picture in May, after the penalty period comes in to play, premium payment issues are straightened out, and most of the rest of the computer messes are cleaned up.
The 18-34 group are the ones to watch. Without them, watch out for renewal quotes for those who signed up this year and started accessing healthcare on day one!
Joe, on your second ED Note, I’ve always believed that smaller networks can be successful at controlling costs in healthcare but only if the incentives to do so are properly aligned to producing better outcomes. Meaning that the doctors are properly incentivized to perform and not just selected based on the ones that provide the best discounts for a service. Frankly the same applies to work comp, chasing discounts is a zero sum game.